Review of Older People’s Residential, Nursing and Home Care Contracts
Kent County Council required support to review their operating model, contracts, fees and market management and brokerage for Older People’s Residential and Nursing Care and Care and Support in the Home. They had significant budget pressures both in the Council and the ICB and had already committed to budget savings of over £10m. Kent wanted support to improve the efficiency of their current systems and drive transformation of the delivery model for what represented their largest area of spend as a council, around £400m per year.
Kent’s working relationship with their local market had been challenging since Covid-19 with several recent restructures and the impact of inflation and the complex geography of the county, alongside the scale in terms of residents needing support and a large and variable market of providers, added to their local challenges.
The Role
31ten was selected to deliver this work based on our adult social care experience, ability to engage with staff, service users and provider markets, and track record of delivering sustainable efficiencies, alongside our evidence of operating at a senior level across local authorities and integrated care boards. There were three core workstreams to our programme:
- Cost of Care: examine the pattern of current and future demands and the true cost of care modelled for Kent through a comprehensive provider engagement programme and subsequent data analysis to determine a breakdown of care costs and returns on operations and capital.
- Joint Commissioning Opportunities: identify where activity between KCC and NHS Kent and Medway is taking place that could provide opportunities for joint commissioning.
- Contracting Models for Support and Care in Kent: determine appropriate contractual models for supporting needs and aspirations more in line with peoples’ preferences.
Key Outcomes
- A mechanism to effect change within their market based on a detailed understanding of their cost drivers as well as national and regional comparators.
- Clear opportunities for enhancing joint commissioning building on a range of local and national best practice examples to drive efficiency. This focused on the development of pathways for complex needs and the opportunity to work better operationally to manage pressures.
- Detailed contract models for both contracts in scope for this review including pricing mechanisms and roadmaps to delivery.
- A transformed model of brokerage delivery focused on supporting greater commercialisation, market management and negotiation and enabling better control of pricing.
- A comprehensive cost and demand model to understand the potential financial benefits of implementing change and adaptable to reflect future changes in population, wages, costs, and demographics.
- Projected financial savings of £10m over 2 years.
The team at 31ten took time to get to know Kent and understand our operating context. They engaged proactively with our teams and our providers to deliver a rounded view of the opportunities available to enact change. The team were diligent and professional throughout and bring a broad range of skills to support project outcomes.
Richard Ellis
Director Adult & Integrated Commissioning – Kent County Council
