Andrew Newens MD Mears Care

A system focussed on outcomes not task

Mears Group

• Task and time based billing takes little account of quality or long term cost reductions achieved

• Single product thinking not service thinking

• Poor partnership working between Commissioner and provider

The ingredients of care today create an unattractive outcome

Housing and taps are different

In the past…Housing maintenance services commissioned on the basis of task and time

Commissioners compared providers on the basis of their cost to fix individual items such as taps

3000 + individual rates, numerous invoices and no incentive to invest in prevention and long term cost reduction

Race to the bottom --Cheapest taps etc

Unhappy customers, rising long term maintenance costs…

Housing and taps are different

Today…..Housing maintenance services often commissioned on the basis of outcomes

Providers provide an overall price per property for all maintenance in the home

Providers tasked with reducingthis over time by investment inquality that lasts

We now buy the best taps that don’t breakdown

Impact…• Customer service levels at all time high

• Real, long term cost reductions achieved

• Risk lies increasingly with the Provider

• Incentivised work force

• Broader outcomes included in tenders e.g.

• Job and skills development

• Investment in community projects

Housing and taps are different

• Quality is the best way to reduce long term cost

• Price for the delivery of outcomes not minutes

• Reward quality of care that delivers real long term cost reduction e.g. reduced residential care, fewer hospital admissions

• Integrate services together- Care, Assistive technology and Community equipment

• Are providers prepared to link their payments to the quality of service they deliver?

Can Care learn from housing?

• The system needs fundamental change not tinkering

• Needs much stronger partnership working between Providers, Commissioners and Service users

• You get what you pay for holds true here!

Conclusion