25.10.2021

Homecare costs outstrip funding from councils

Access to services News isolation social care Rural Vulnerability Rural Access to Health and Care Services Rural Fair Funding

The BBC has detailed how a recent report shows many councils are not paying homecare companies a high enough hourly rate to cover basic costs like travel time between clients

It means, despite losing staff faster than they can be replaced, companies are unable to raise wages, says the Homecare Association.

Low wages and feeling undervalued are key factors leading care staff to quit, says the report.

Councils say they do not have enough money to pay companies more.

The Homecare Association, which represents some 2,340 care providers, calculates the true minimum cost of providing an hour of homecare in the UK is £21.43.

This covers the minimum wage, travel time, pensions, holidays, training, PPE, office staff and 60p for profit or reinvestment in services.

Freedom of Information data collected for the Association shows the average paid by councils in Great Britain and health boards in Northern Ireland is £18.45.

Full article:

The BBC - Homecare costs outstrip funding from councils, says report

The State of Care in County and Rural Areas, released by the County Councils Network (CCN) and the Rural Services Network (RSN), provides an overview of the challenges in delivering adult social care in rural and county areas, and provides the first detailed analysis of the impact of the government’s social care reforms.

Social care reforms will protect more individuals from large care costs but will not improve access to care and could make local care markets ‘unsustainable’, the report warns

According to the report the government’s reforms will protect more people from large care costs, but they will not improve access for the hundreds of thousands ineligible for services, whilst they could destabilise care markets and providers in counties.

Revitalising Rural: Realising the Vision is a campaign led by the Rural Services Network to challenge Government on a number of policy areas that affect rural communities.

The campaign features on a number of topics which are pertinent across rural communities and one of these areas is 'Access to Rural Health and Care Services'.

The health and wellbeing of the nation’s population is as relevant to and important for rural communities as it is to those who live elsewhere. This universality is embedded within the vision that led to the creation of our National Health Service.

Surveys of rural residents and of those who represent them consistently find that health and care services are one of their top priorities. This may, in part, reflect the older demographic residing in mostly rural areas (which is not a reason to overlook health and care issues affecting younger age groups). It is likely to be even more true following the Covid-19 pandemic.

Health services that serve rural populations need to be safe and of high quality. They also need to be geographically accessible. This can lead to a dilemma, often not well resolved, where services become more specialised and centralised, but are then more distant from rural communities.

The asks in the Access to Rural Health and Care Services chapter of the Revitalising Rural campaign which is relevant to the above news story is shown below:

Access and travel to hospitals: local health partnerships (STPs and ICSs) and trusts should take better account of accessibility and transport availability when drawing up plans to reconfigure acute and emergency services at their main hospital sites. This should address access for patients, visitors, and staff from rural locations, including those without a car or those unable to drive. It is especially important for patients whose treatments require a regular visit. Hospital transport schemes should also be made more widely available. This and other issues would be easier to address if funding allocations to local NHS areas were better aligned with the costs rural areas typically face from serving an older aged population. The hospital building programme should be used to improve access to hospitals in rural areas which are not well served.

Primary and community care services: local health partnerships should seize opportunities to create locally based multi-disciplinary teams and to develop health hubs in rural town locations. Hubs should aim to make a wide range of treatments and services more accessible to nearby rural populations, thereby avoiding the need for many patients to travel to main hospitals. They should provide services such as minor procedures, diagnostic tests, baby clinics, rehabilitation, and re-enablement. Local pharmaceutical services need to be retained in rural areas, which in some cases means supporting dispensing GP surgeries.

Social care provision: Government should implement the findings of its Fair Funding Review to help level-up the provision of social care services in rural areas, taking full account of their delivery cost in more sparsely populated areas. This would also enable improved or more consistent engagement with and commissioning of ‘low level’ support services for vulnerable rural residents, which are typically delivered locally by voluntary and community sector organisations.

Workforce and recruitment: Government and the NHS should ensure that delivery of the NHS Workforce Plan includes an explicit rural dimension. Pay bonuses should be considered to attract recruits into those rural places with the highest vacancy and turnover rates. Medical training should include a rural placement, wherever possible, to give trainees exposure to work in rural settings. Similar initiatives are needed to cope with serious rural shortages in the social care workforce.