The media attention of recent weeks has brought pressures in social care to the forefront, pointing out the strains in the service of which practitioners are all too well aware. CIPFA aims to support the system by providing a range of resources focused on improving efficiency and sustainability.
It makes sense, given that focus, for the benchmarking club to work collaboratively with the Health and Social Care Finance Advisory Network (HSFCAN), which focuses on disseminating good practice, and to that end collaborative events are planned during 2017–18.
Figures from the current members of the benchmarking club give some idea of the potential scope to improve. The rate of occupation for in-house residential care ranges from 46% to 99% with a lower quartile of 64% compared with an upper quartile figure – a reasonable indicator of best practice – at 96%.
Given that a high proportion of residential care costs are fixed or semi-fixed, that difference is likely to translate to something close to a third in unit cost impact. Clearly, understanding the relevant factors could make a big difference to the poorer performing authorities here.
Looking at external placements, the average cost per resident week is a key cost driver. Analysis of club members’ returns shows the lower quartile of £702 per week for those over 65 compared with a media of £784 and an upper quartile figure of £993, so most expensive are paying 40% more than the authorities buying at the lowest cost.
Some regional variation in costs is to be expected, but not to anything like that extent. There is, it's true, a difficult balance to be struck between obtaining the best value for money for taxpayers and ensuring that prices are sufficient to enable providers to remain sustainable in the long term.
Yet that equation, which was the subject of a recent set of HSCFAN events and will also be covered by publications from both the Department of Health and CIPFA, is one which almost all authorities must strive to solve. It is not, in itself, a reason for such variations.
All authorities need to look closely at their comparative unit costs in the very substantial and severely pressured area of social care spend to ensure that they maximise efficiency while maintaining an effective and sustainable market. We hope that these three areas will help provide ideas and support during this challenging time, and would also be delighted to hear from practitioners with ideas for any further areas.