Homecare providers are going through both hard and interesting times. On the one hand there is significant tightening of local government spend and extreme focus on cost per hour; on the other hand, a combination of a rapidly ageing population and real political will to move towards more healthcare delivered in the home.
What can homecare providers do to improve margins and build valuable organisations for the future? Fundamentally, we believe there are only a small number of strategic options. In this article we look at how to move away from the relentless focus on ‘cost per hour’ to delivering homecare that focuses on solving maybe the biggest problem in health and social care: reducing unscheduled hospital admissions.
Homecare should focus on solving bigger problems
In the longrun, homecare providers will only be profitable if they can solve the most pressing problems. In the short term ‘winter pressure’ is getting a lot of coverage. The onus on both the NHS and social services is likely this winter to lead to A&E departments up and down the country being filled up with the old and frail whose conditions worsen with cold weather and the flu season.
Our view is that going forward, homecare providers must ‘up-skill’ and be able to deliver higher acuity, more complex services at home. These services range from medication management and light dementia care to complex hospital at home provision.
The reality is that commissioners are going to commission – due to budget pressures – fewer and fewer hours for traditional homecare. But because of the much superior cost proposition of ‘hospital at home’, commissioners are likely to shift budgets form acute hospitals to providers of higher acuity homecare services.
What is required to delivery higher acuity?
Politicians of all colours agree; patients should be moved out of hospital and service users should be moved out of residential care. So what does it take to delivery higher acuity services?
We believe there are several capabilities and technologies that homecare providers can acquire to become credible providers in this space.
At the core is combining homecare providers’ ability to cost-effectively recruit and train carers on the ground with clinical governance and robust processes. In essence, homecare providers need to become case managers in the field.
We believe mobile technology has a key role to play in ensuring the ability to deliver and document safe care and better outcomes. At is most basic level is its ability to flexibly deploy rota and verify visits (who is delivering what, where). At a more sophisticated level is the ability to send patient health records and care plans to mobile phones and to enable detailed information capture in the field. Good examples here are the delivery of check lists (e.g. for wound care and medication) to questionnaires to regularly measure hospitalisation risk.