Burstow Commission on Homecare Workforce
A radical rethink on the commissioning of services for people receiving care at home and the terms and conditions of the homecare workforce is urgently needed, says United Kingdom Homecare Association (UKHCA) as it welcomes the publication of the Burstow Commission’s report “Key to Care” on the future of the homecare workforce (note 1).
We commend the Commission for seeking the views and experience of a wide range of stakeholders from England’s homecare system, including UKHCA.
Commenting on the Commission’s recommendations, UKHCA’s Policy Director, Colin Angel, said:
“Older and disabled people deserve excellent services from a workforce which is suitably trained, committed and adequately rewarded for the increasingly complex care required to be delivered at home.
“Homecare workers are our greatest asset and their services already support demands on a struggling health service. However, inappropriate commissioning by local councils is self-defeating and carries risks of rushed, undignified services which lack continuity by focussing on limited time for care and a constant pressure to reduce providers’ fees.
“It is essential that local councils reflect on the Burstow Commission’s findings to move away from ‘time and task’ commissioning and refocus on purchasing effective outcomes for individuals and also value the homecare workforce appropriately.”
This Association endorses the Commission’s view that there is a significant risk of high quality care providers being driven out of the sector by a race-to-the-bottom in the prices paid by local authorities, who purchase over 70% of all homecare services delivered.
We are pleased that the Commission has endorsed UKHCA’s recommendations on the minimum prices councils should pay for care to enable compliance with at least the Minimum Wage for careworkers and ideally the Living Wage (notes 8 & 9).
We agree with the Commission that where individual councils do not accept UKHCA’s minimum price they must be able to justify its decision with an alternative model, with oversight from the local Health and Wellbeing Board before sign-off.
In addition, we support the Commission’s call for an open-book approach to pricing from councils and providers. UKHCA’s on-line costing model provides a suitable tool to undertake this process (note 10).
These recommendations support recently issued statutory guidance to local councils issued under the Care Act 2014 (note 11).
In addition to a real-terms reduction in prices paid for homecare in recent years, UKHCA condemns the growing practice of “reverse electronic auctions”, with councils requiring local providers to bid increasingly low prices to provide care to older and disabled people.
We welcome that the Commission’s proposal for a ‘license to practice’ for social care workers, which will build on the forthcoming Care Certificate. This recommendation goes considerably further than the current proposals from Government and the Health and Care Professions Councils (HCPC) for either a ‘voluntary’ or ‘negative’ register of workers (note 12).
A suitable licensing regime has the potential to raise the status of care work and encouraging greater investment in the training and development of the workforce. We hope that Government give full consideration to this recommendation.
Reversing the current trends of homecare commissioning will pay dividends for home-based care, delivering better outcomes for people who use homecare services, providing greater continuity from reduced staff turnover and prioritising spend where it will be most effective.
Ends.
Notes for Editors
1. The Commission, chaired by Rt Hon Paul Burstow MP, launches its report on Tuesday 2nd December 2014. It will be available from www.lgiu.org.uk.
2. United Kingdom Homecare Association (UKHCA) is the professional association for more than 2,200 domiciliary care providers in Great Britain and Northern Ireland.
3. UKHCA’s mission, as a member-led professional association, is to promote high quality, sustainable care services so that people can continue to live at home and in their local community. We do this by campaigning, and through leadership and support to social care providers.
4. UKHCA has a vetting procedure for its members, all of whom agree to abide by the Association’s Code of Practice, which can be found at www.ukhca.co.uk/codeofpractice.aspx.
5. UKHCA represents 33% of independent and voluntary sector providers in the UK. There are over 9,100 registered homecare providers across the UK, the majority of which (84%) are in the independent and voluntary sectors. We estimate that these organisations employ over 438,000 homecare workers, who deliver over 6.29 million hours of care per week to around 536,000 service users, valued at £5.2 billion per annum.
6. Homecare encompasses provision of personal care, to people in their own homes. For many, homecare is the alternative of choice for people who would otherwise need to move into residential accommodation.
7. The majority of homecare is funded by the state (usually by local council social services departments, Clinical Commissioning Groups (CCGs), or Health and Social Care Trusts in Northern Ireland). However, homecare services are largely delivered by independent and voluntary sector providers working under contracts with the statutory sector.
8. UKHCA’s Minimum Price for Homecare explains the assumptions necessary to calculate the full costs of homecare that councils must pay for full compliance with National Minimum Wage (£15.74 / hour), the UK Living Wage (£18.59 / hour) and the London Living Wage (£21.33 / hour). See: www.ukhca.co.uk/downloads.aspx?ID=434.
9. An infographic illustrating the costs of homecare at the current minimum and living wage rates is available from www.ukhca.co.uk/pdfs/minimumpricehomecareinfographic20141103.png.
10. UKHCA’s Costing Model is available at: www.ukhca.co.uk/CostingModel/.
11. Paragraph 4.35 of the Department of Health’s statutory guidance on the Care Act 2014 states “The local authority may be the most significant purchaser of care and support in an area... Local authorities must not undertake any actions which may threaten the sustainability of the market as a whole, that is, the pool of providers able to deliver services of an appropriate quality – for example, by setting fee levels below an amount which is not sustainable for providers in the long-term.” (Emphasis in the original). See www.gov.uk/government/publications/care-act-2014-statutory-guidance-for-implementation.
12. For more information, see UKHCA’s correspondence with the Health and Care Professions Council (HCPC) at www.ukhca.co.uk/downloads.aspx?ID=446.
13. Regularly updated statistical information about homecare services in all four UK administrations is available from "An Overview of the UK Domiciliary Care Sector" at www.ukhca.co.uk/downloads.aspx?id=109.
14. High resolution royalty-free images of Colin Angel, Policy and Campaigns Director is available from:
www.ukhca.co.uk/images/highres/angel_colin_20140701_079.jpg.
15. Interviewees from UKHCA for broadcast media are available on request.
16. For further information please contact:
Colin Angel, Policy and Campaigns Director
United Kingdom Homecare Association Ltd
Sutton Business Centre, Restmor Way, Wallington, SM6 7AH
Telephone: 020 8661 8188
Mobile: 07920 788993
E-mail: [email protected]
Website: www.ukhca.co.uk
Registered in England, No. 3083104.
