The chief executive of United Kingdom Homecare Association (UKHCA) said she would scrap the commissioning of social care services by local authorities if she were in charge of the country.
Giving evidence to the Health and Social Care Select Committee yesterday, Dr Jane Townson said the UK needs to do away with a commissioning system that treats care workers – and the people they care for – as “commodities”.
She also emphasised the value of putting people at the centre of commissioning arrangements with person-centred planning.
“I often observe that the self-funded part of the home care market points the way to how we could do things because, in that part of the market, the people are the commissioners,” she told the committee’s chairman and former Health Secretary, Jeremy Hunt.
“In my world, I would abandon local authority commissioning and I would stop the micromanaging that goes on and allow [care staff] to work with the people that they are supporting to agree and decide on what can be offered within the budget.”
Dr Townson also stressed the importance of stopping the payment of home care workers by the minute.
“Councils buy care by the minute, which means that providers have to employ by the minute. Nobody wants to do that, but it’s the system that’s wrong and it’s that feeling of not being able to meet people’s needs,” she said.
“Imagine a clinical commissioning group saying to an NHS Trust ‘we’re only going to pay nurses for every minute that they are by a patient’s bedside and we’re going to electronically tag them to find out when they are there, but we’re not going to pay them when they’re moving from one patient’s bed to the next and we’re not going to pay them when they are training’. Can you imagine the outcry?”
“On top of that, the NHS Trust would have to pay for all of those additional things, by some miracle, in some way. That is what home care providers have to do and are expected to do every day.”
Raina Summerson, the chief executive of Agincare, also criticised the practice of paying home care workers by the minute, which she said was a result of restricted public funds for home care services.
“Who would have thought that this critical role of compassion and care could be broken down to paying people by the minute and having people … not be paid for when they are walking up someone’s garden path,” she said.
In response, Hunt said he would urge ministers to rethink the practice.
He said: “I think it is something we need to talk to ministers about. When I was health secretary, I was told 15-minute visits had been abolished, but it feels like they haven’t. It is definitely something we need to look into.”