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Better Care – A Better Way?

09/11/2020
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This thought-provoking piece has been contributed by Peter Wingrave, Sales Director at AAT GB. “Build back better” is a mantra adopted by the government in the face of the coronavirus pandemic. Now is the moment to put it into practice and find a better way to deliver better care.

It is great to hear the Government is allocating more money to the Better Care Fund

We all acknowledge that the concept of the Better Care Fund is great. How can anything designed to better the lives of people not be good? 

Its administration, not so good. Even the National Audit Office concluded the Fund had failed to achieve planned savings or reductions in delayed transfers (note 1 below).

Whilst the size of the pot matters, adding more money will not increase delivery of results unless there is a fundamental change in the process.  

Unnecessarily conservative view of risk

The underlying problem, to quote the issues recently at Motability, is 

“an unnecessarily conservative view of risk.”

In other words, administrators hold the purse strings, and work solely on fiscal motivation. Any Key Performance Indicators that are in place are vague in nature, further exacerbating the situation. 

There is no holding validation of where the money is being spent and more importantly, what results are being achieved. This means no-one is truly accountable or fundamentally guiding the budget.

The over-arching aim of the Better Care Fund – to deliver services that enable people to get home, and stay home and to do so faster and better – has been forgotten or overlooked by the management.  

Mismatch between commanders and troops on the ground

The ground troops – the Occupational Therapists and their fellow healthcare professionals have NOT forgotten. They are trying to do their best. The problem they face is historic – of looking at the end objective, of providing a complete solution / adaptation.

What we suggest is a fundamental change of approach, a redirection of management attention back to the core aim: to empower people to get home, and live at home. 

It needs, at the point of delivery, a change in the balance of power, to the people qualified to find and deliver solutions – the Occuptional Therapists. The financial administrators should be there to ensure rules are followed but only to avoid abuse of process.  

Change of mindset required

We also need a fundamental restructuring of approach in the delivery of better care: to address all ‘life stages’ of getting someone home and enabling them to continue independent living. The adaptation is the culmination, but there are steps inbetween that expedite immediate and short-term solutions.

It would address the backlog, the delay, and deliver a better outcome. More often than not too, it provides best value: equipment to expedite the interim solution is often already available in equipment stores, and can be re-issued, time and again. 

As anyone running a commercial organisation will tell you, when the fundamental intention of the exercise is not working, the one option not available is to do nothing!  

Silver bullets fly too slowly…

Therefore, with great respect to all concerned, I would suggest BCF leadership accepts that single silver bullet solutions do not exist swiftly enough, and open their minds to interim cost effective measures. 

Discard the unnecessary and illusory, slavish devotion to the term ADAPTATIONS. Engage and trust the knowledge, experience and capability of OTs. Get the cash on the ground, where so many deserving people and organisations are in desperate need.  

Pandemic shines a critical light

Covid has only served to highlight the problem which was already there. Especially in such unique and difficult circumstances, the greatest sin is to fail to get huge resources – which do exist, are available, and would bring huge relief to disabled individuals, stressed hospital teams and community housing teams – into effective play.

Together, we can find a better way, and deliver better care.

Thoughts please…

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