Outcomes-based commissioning can't work if commissioners have no real sight of outcomes

A startlingly candid, wide-ranging discussion in which LGiU’s Ingrid Koehler and Harringey’s James Cuthbert agree that commissioners, providers and families have little real insight into those 15-minute homecare visits.

But understanding, and acting upon what the cared-for person really wants to achieve, whether its being able to make their own cup of tea, or getting out on the balcony three times a week, is absolutely key to being able to improve wellbeing and very likely also, achieve savings to health and care budgets.

Ingrid describes how the LGiU is working with Kingston and Southwark councils to pilot ‘Co-care’ an app that enables carers to record and share information not just that a visit took place and when, but also what progress has been made, or setbacks encountered, in moving towards the cared for person’s goals.

This information, shared with permissions in the hands of the cared-for person as ‘data controller’, allows commissioners, providers and families to assess the quality of the activity on the basis of real information.

Getting to this point from the current situation of traditional statutory reporting of visits is difficult, our panel agree, and the discussion about challenges ranges across pay, training and qualifications of the care workforce; the turkeys-voting-for-Christmas predicament of care middle managers; the difficulty of changes that deliver savings into a different part of ‘the system’; and whether social care would be better managed by the NHS (a resounding no!).

This is a long video, but worth watching every minute.

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