CPA Members on Funding and Commissioning
Individual trade associations which belong to the Care Provider Alliance are responding to concerns about funding and commissioning arrangements. We are collating and sharing their responses and useful resources below.
All adult social care services§
An Introduction to Personal Health Budgets - revised elearning module
This online training is intended to support all staff who are involved in the delivery of personal health budgets. The module covers a variety of topics including: the legal right to have a PHB, budget management options, and what a PHB can and cannot be spent on. It also offers guidance on the steps involved in implementing andmaintaining a PHB, and the key features that ensure people experience the best outcomes possible.
To find out more and access the revised elearning module, visit the Personal Health Budgets elearning page
Local Authorities were required to publish their Cost of Care exercise findings by the 1st February 2023. Each report should set out how the cost of care estimates were arrived at. The reports cover care home services for adults aged 65 and over, and separately, domiciliary care. Find links to all local authorities’ reports.
Learning disability and autism services§
The Fee Rate Interactive Map has been designed by ARC England to be a tool for collaboration between commissioners and providers of services to adults with learning disabilities or autism in forthcoming conversations about fee rates and inflationary uplifts. ARC England would therefore like to invite all local authorities to use the interactive maps as a benchmarking tool when setting fee rates and uplifts with providers.
Over 80% of local authorities provided their fee rate data in response to ARC England’s Freedom of Information request and the map shows a wide variation in fee rates between areas in England and Wales. It can be seen that in many local authorities’ fee rates have fallen behind provider costs and that annual uplifts have not kept pace with inflationary pressures.
- In supported living services, where staff wage payments represent approximately 85% of providers’ costs, the 2019-20 National Minimum Wage increase by 5% to £8.21, resulting in a rise in operating costs of 4.13%.
- By 2022-23 the NMW increase to £9.50 made an operating costs rise by 8.23%, in a sector already hit by severe recruitment and retention problems, due in part to low pay and competition from rival sectors like retail and hospitality which can afford to pay higher wages.
New research by the Homecare Association indicates that over 8 in 10 (80%) of homecare providers that hold contracts with the NHS and local authorities have experienced late payments. Nearly half (47%) of homecare providers say almost all of their invoices are paid late.
Late payments have a significant impact on businesses, leading to cash flow difficulties, which can affect their ability to pay bills and the business’s own suppliers. Without predictable payment terms, homecare providers find it difficult to remain sustainable, invest and expand.
Worryingly, the survey also found that 8 in 10 of respondents who are being commissioned by local authorities have experienced a reduction in the number of hours available to them to provide. Reduction in volume of hours available per provider appears to be a particular issue in local authority areas which rely heavily on framework contracts. Where local authorities commission to a limited number of lead providers in specific geographic zones, volume of hours has remained more constant.
The Homecare Association has published its Minimum Price for Homecare for April 2023 to March 2024. This minimum fee rate for purchase of homecare by local authorities and the NHS has been calculated at £25.95 per hour. This allows for full compliance with the National Living Wage (£10.42 per hour) and the delivery of sustainable, good quality, regulated homecare services.
The minimum price has increased from last year (£23.20 per hour) due to a 9.7% increase in the National Living Wage from April 2023, and inflation in operating costs, including sky-high fuel prices and rising rent, rates and utilities.
It is important to stress that the Homecare Association believes care workers should be paid much more than the legal minimum to recognise the skill and responsibility of their roles and to improve retention and recruitment of staff. Also reported are calculated fee rates required to enable payment of the Real Living Wage (£10.90 per hour), a wage equivalent to NHS Band 3 with 2+ years’ experience (£11.85 per hour), the London Living Wage (£11.95 per hour) and a competitive labour market wage rate (£13.64 per hour) of between £26.79 and £31.55 per hour. Many providers are already paying above the national minimum wage, some as high as £15-17 per hour, but this is only possible with hourly fee rates to match.
Mental health services§
In mental health, it is estimated that more than two million people are unable to access specialist care and support services. View the Association of Mental Health Provider’s app which highlights the disparity of mental health services access across England.
Over 8 million people are supported by mental health charities – that is 1 in 8 of our population – and a survey of the Association’s 300 plus members has revealed:
- a 100 per cent increase in waiting times for access to specialist referral and crisis services since summer 2022.
- a 50 per cent rise in people presenting with increasing needs, particularly with anxieties related to money and housing because of the cost-of-living crisis.
The Association’s new #MHEqualityNow campaign aims to raise awareness of the exponentially rising unmet need for mental health services, and is calling on the Government to recognise the critical part mental health charities play in delivering mental health services by committing to sustainable ongoing and future funding for the sector.