Maria Mills, CEO
Maria's thoughts, opinions and news.
Posted on 02 November 2011, 16:40pmDisruptive Innovation
At SCA we are absolutely delighted to be chosen as one of 4 finalists for the Guardian Social Enterprises Awards 2011 – feedback from the judges praised our ‘disruptive’ business model in health and social care. I must admit I did not have a clue what it meant so promptly did a bit of research, so now hopefully I can testify why we are indeed disruptive!
Then after speaking at the ACEVO Health and Social Care conference last week I picked up a document by Paul Corrigan on Saving the NHS info@acevo.org.uk – and the potential huge role of the third sector to transform relationships particularly in supporting people with long term conditions to be at the centre of health activity (theirs – which delivers the most value, ours, medical). Again disruptive innovation is named as how this needs to happen.
Will the NHS reforms, new bodies and commissioning relationships really change things - the current ‘NHS’ has a shell around it and so many vested interests to keep much the same, and I still cannot see how integration between health and social care is going to happen in a big way. But with the huge challenges ahead in relation to health ‘demand’ in a conventional sense the current model is not going to work. But people created the NHS and somehow we need to get people back at the centre of how health care is supported over a lifetime.
We need show how our disruptive model, and that of many others, can radically transform people’s wellbeing.
People Shaped Care
At SCA we are going through a fundamental change process as we really address how to provide truly people shaped care and support services. We are using a partner Frameworks4Change to assist us on this journey – and how we profoundly listen to our members and support them on the things that really matter to them. Whilst our staff and members are really committed to enabling more creative care we do have some real challenges.
We are still largely commissioned for public services in adult social services for older people by lists of personal care tasks to be done in 30 minute slots. Some of our public sector rates are at £11 - £13 per contact hour in our members’ homes – we are not paid for time to travel between people’s homes, fuel, member assessments and reviews, staff training, clinical case reviews and practice development, staff holidays sickness and maternity payments, staff management, care arranging, member involvement, community engagement to add value to our members experiences and opportunities, office costs, volunteer costs , finance and invoicing costs, IT and HR and so on. Therefore for us to even try to break even, our care staff are not paid as much as we think they are worth. Indeed our society appears to have deemed that people can be paid more for tacking shelves in Tesco’s at the weekend.
Our Care staff have complex roles and there is real skill in providing compassionate respectful and calm care where our members are truly at the centre of our approaches. Providing personal care is not easy, many of members have conditions whereby sometimes their behaviour is challenging, their needs often change and require skilled assessment and management, that also support greater independence. Yet we can and do dramatically improve the quality of people’s lives.
But we still feel we could do so much more.
We feel that outcomes based commissioning should be real – and that we should be paid at the right rate for the results we deliver. Our customers should all be given a budget and choose what and how they should spend it on the things that matter to them.
We have a whole long list of the things we can do to attract more resources into our work with our members who are largely from the more disadvantaged parts of our communities. From cross subsidising from customers who can afford to pay more, better locality working, community and people asset development, creative income generation, cross subsidising from our consultancy work, more empowered ways of working and so on. We are developing more niche services that are valued at a premium. We are developing better career pathways for our care staff and increasing their pay rates to better match competencies and excellent work.
We will need to think about those public sector contracts where we are not going to be paid at a level which support quality services and do not do them.
We need to campaign and work collaboratively to highlight that the results that good care staff deliver are worth so much more. We envisage that our care staff in the future will be more empowered to support member shaped self-care and social community and service circles that deliver more sustainable independence, and who also deliver directly a fuller range of health, care and community interventions as and when our members require. This way our members get someone they know, trust and work with them as a whole person as long as they need it enabling them to have the best quality of life.
Let people shape their own services from the people closest to them.
