A system focussed on outcomes not task Andrew Newens MD Mears Care

Mears Group

The ingredients of care today create an unattractive outcome Task and time based billing takes little account of quality or long term cost reductions achieved Single product thinking not service thinking Poor partnership working between Commissioner and provider

Housing and taps are different In the past… Housing maintenance services commissioned on the basis of task and time Commissioners compared providers on the basis of their cost to fix individual items such as taps 3000 + individual rates, numerous invoices and no incentive to invest in prevention and long term cost reduction Race to the bottom --Cheapest taps etc Unhappy customers, rising long term maintenance costs…

Housing and taps are different Today….. Housing maintenance services often commissioned on the basis of outcomes Providers provide an overall price per property for all maintenance in the home Providers tasked with reducing this over time by investment in quality that lasts We now buy the best taps that don’t breakdown

Housing and taps are different Impact… • Customer service levels at all time high • Real, long term cost reductions achieved • Risk lies increasingly with the Provider • Incentivised work force • Broader outcomes included in tenders e.g. • Job and skills development • Investment in community projects

Can Care learn from housing? Quality is the best way to reduce long term cost Price for the delivery of outcomes not minutes Reward quality of care that delivers real long term cost reduction e.g. reduced residential care, fewer hospital admissions Integrate services together- Care, Assistive technology and Community equipment Are providers prepared to link their payments to the quality of service they deliver?

Conclusion The system needs fundamental change not tinkering Needs much stronger partnership working between Providers, Commissioners and Service users You get what you pay for holds true here!