Issue details

Proposed decision:

Approve the fee uplifts for Adult Social Care Providers for 2023/2024 and delegate authority to the Corporate Director Adult Social Care and Health to take relevant actions, including any changes to the percentage uprates, as necessary to implement the decision.

Reason for the decision: 

In previous years, practice has been to increase provider fees across services at a standard, blanket, percentage rate, in accordance with stipulations in the contracts, either relating to average changes in the CPI (Consumer Price Index) or other review clauses. Constraints in available funding coupled with both the cost-of-living crisis and recent increasing inflationary pressures have had a material impact on the profitability and, in some cases, the viability of care providers in the light of current fees paid by local authorities.

The proposed allocations are those which are affordable in the Council’s recently agreed budget.

Due to various market pressures facing the sector it is proposed that the percentage fee increase paid to framework providers, varies according to the service provision, in line with the budget availability and the Adult Social Care Making a Difference Every Day approach. Leads from Commissioning and Finance have scoped the impact of each service, applying the percentage award to fees based on market sustainability factors.

The Homecare sector has the greatest current issues with supply and cost control owing to market pressures specific to it. This has led to an increasing reliance on non-contractual spend, with 45% of homecare packages purchased off contract in January 2023 compared to 18% at the beginning of the 2021/22 financial year.

Conversely, failing to increase fees for framework providers sufficiently leads to a reduction in framework capacity and supply, an increasing reliance on non-framework provision, and significantly increased costs. To a lesser extent, there have been similar impacts on the Older Person’s residential and nursing care market. It is therefore proposed to apply differing standard percentage rates to different services to ensure markets are managed appropriately. 

Options (other options considered but discarded):

• Apply standard percentage uplift across all service provisions: this was discarded as it would not allow sufficient funding to be allocated to homecare provision to address the specific market pressures highlighted above, so that off-framework contract spend can be controlled in an effort to reduce overall costs.

• Apply no uplifts across all services: this was also discarded as market pressures and inflationary costs are already leading to placement officers having no choice but having to purchase more expensive packages of care off contract.

How the proposed decision supports the Framing Kent’s Future:

The decision supports Priority 4 of the ‘Framing Kent’s Future’, to ensure the sufficiency of the market of social care in Kent, and work with providers to address the supply issues in certain parts of the county where geographic or workforce challenges impact on provision”.

Financial Implications:

Table 1 below shows the proposed percentage fee uplift, as a proportion of the overall provision in the budget. The first section represents those services where a standard percentage uprate will be provided to all framework providers.

Providers on individual (non-framework/INDI contracts) will receive no automatic uprate to their fees although, additional funding is available for individual price negotiations. Allocation of this funding will be governed by the development of a standard approval process based on the financial viability and benchmarking of the provision in question.

The exception to this is Equipment provision for which provision has been made based on 5% of the net equipment forecast and included as part of the provision for other price negotiations.

Table 1 – Price Uplift – Budget Impact 2023/2024

** The general uprate is 6% for framework provision across Supported Living (SL) and Supporting Independence (SIS) Services, but within this, service elements relating to sleep night rates will be increased by 9. 68% to maintain parity with the National Living Wage.

Data Protection implications:

A Data Protection Impact Assessment is not required as there are no material changes to the way in which personal data is handled, nor the way in which it is used. Similarly, this work does not involve data profiling or changes to the way in which special category data is handled.