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

2. Mears Group

3. 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

4. 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 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…

5. 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

6. 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

7. 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?

8. 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!