The delivery of social care is going through fundamental changes. Although budget cuts dominate the headlines (they will for the next 12 to 24 months), the real question is how to provide better, more cost-effective social care. The future is personalised, outcome-based care at home or in the community commissioned jointly by councils and primary care trusts. Flexible case management systems are required to capture outcome data and MI both for funders and providers.
Two big changes have occurred in England over the past 10 years. Firstly, we have seen a significant shift way from institutions and residential care to home and community care. Secondly, over the past decade local authorities have shifted from use of in-house staff to outsourcing the provision of homecare to a growing independent sector, thereby created a market of over approximately £5bn.
Whilst this outsourcing has been largely successful, it has led to a culture of measuring care in number of hours. There has been little focus on increasing service users’ independence and measure outcomes. However, this is about to change. Reablement, a process by which a short burst of support, rehabilitation and training is provided to increase service users’ independence and reduce the need for ongoing care, will fundamentally change homecare. A number of recent studies suggest that the need for homecare can be reduced by as much as 60% through Reablement programmes.
Legacy IT systems have been identified as a one of the barriers to implementing successful Reablement services. Reablement requires a new process and new case management solutions. Outcome reporting and good management information is absolutely vital. In the new world, we expect key stakeholders to collaborate online and outcome reporting to be integrated into the Reablement process. This will ensure value for money and provider benchmarking for councils and a tool to deliver effective reablement for providers.
What is the role of electronic call monitoring? Electronic call monitoring to record how much time is spent by carers with individual services users will continue, however, with emphasis on outcomes, the tracking of time spent will become more a means to understand the effectiveness of Reablement. Ultimately providers will get paid for generating good outcomes – not just delivering hours of care.
Given the severe fiscal outlook, councils and providers alike should look to fully-hosted SaaS (software-as-a-service) case management solutions. Software providers, such as psHEALTH, deliver solutions with no upfront cost or investment in hardware or ongoing infrastructure maintenance. The only thing stakeholders need is access to the internet.