For decades, the UK’s domiciliary care sector could only measure the delivery of care upon the basis of quantity. Despite the wholly personal nature of the service; time and task was literally the only metric that could be applied to determine the efficiency and effectiveness of a team, a business or a contracted provider.
It is broadly acknowledged that this status quo was changed in 2015 by the launch of the PASSsystem from everyLIFE Technologies. Suddenly it became possible to measure quality as opposed to quantity and, most importantly, that “quality” could be readily assessed from the perspective of care receivers, provider and commissioner alike. The whole value chain was positively impacted and the country’s appetite for digital care plans was ignited.
Over the following three years, digital care plans have been adopted by many hundreds of care providers across almost every commissioning region in the UK, each driven by their three overlapping objectives of service excellence, cost efficiency and compliance (evidence of care).
This is a low-margin industry, which, at the time, still had the sleep-in question hanging over its head, so the PASSsystem’s clear financial and efficiency gains drove this huge uptake amongst care providers. At the same time, the regulatory and commissioning bodies all had the unusual opportunity to observe this transformation from a safe distance and, critically, to challenge and measure the visible improvements to quality, safety and transparency. As a direct result, digital care plans are now proven and expected norm in the UK and are often the mandated basis for the outcome, or quality, driven care. This is now true in both privately and centrally funded settings and it is telling that a number of other software providers are beginning to launch entry-level products into this space to promise choice and competition further down the line.
As with any transformational technology, the early uptake of digital care planning has been fastest within the small to medium enterprise (SME) segment, where the immediate financial gains can often make a sink or swim difference and where the agility of a small management team means that strategic change is, frankly, very much simpler to take head-on.
We have seen an inevitable inertia within the larger groups and providers, for whom the cost and pain of such strategic change must clearly balance operational gains against the risks of a major project. Of course, with such new technology, they must also accommodate the risk of their software or their software provider failing along the way and bringing everything tumbling down.
However, with consumers and commissioners now demanding a digital approach, and with plenty of evidence supporting the value, 2018 has seen the very largest care providers in the sector actively preparing to implement digital care plans. To mitigate their risk, Tier 1 providers rightly demand a number of safeguards from their software supplier including, as standard;
- A lifetime system functional warranty
- Warranted support SLA including service credits in the event of failure
- Warranted availability SLA including service credits in the event of failure
- Clear and equitable contractual provisions
- Fixed-price, no-surprises pricing model
- Comprehensive escrow provision for software, data and infrastructure
- Contractually-binding rollout timeline with matching phased payment plan
- Unlimited user count to accommodate mergers & acquisitions
- Burstable licence model to accommodate unpredictable peaks without additional cost
- NHS-standard information governance and appropriately qualified staff
- Strict and transparent corporate governance rigour
As ever, this sector will continue to evolve, and the goalposts will continue to move. But in the space of just 36 months, digital care plans have matured from novelty to normality and, across the whole range of UK providers, has changed the way that we deliver care and measure care in the home.