Review on one-to-one care reduces overspending and improves patient outcomes
Oxford CCG found that there was a noticeable increase in additional one-to-one care packages given out in the Oxford area, which led to a review to explore the reasons for and solutions to the sharp rise in provision.
£29,500 immediate savings per week
£1,500,000 savings per annum
The Challenge
Oxford CCG found that there was a noticeable increase in additional one-to-one care
packages given out in the Oxford area, which led to a review to explore the reasons for and solutions to the sharp rise in provision.
A number of factors were found to be causing the increased award, including national factors such as the Covid-19 pandemic, high continuing care loads, and elevated staff sickness. Locally, they found that the OCCG and Oxford Health process was also contributing to the over-provision.
Liaison Care was asked to examine the end-to-end process, and make recommendations to improve the clinical and social outcomes for clients. This included ensuring the use of least restrictive practise to support individuals in a nursing home placement currently receiving one-to-one care, and offering insight into the financial situation surrounding additionally funded one-to-one care packages across the region.
As the review commenced, an increased spend from £1million to £4.5million was predicted in the area of one-to-one care alone.
The Solution
Liaison Care’s clinical experts initially reviewed 34 cases and found there was an opportunity for immediate reduction on financial expenditure, if the recommendations were agreed to and followed.
The reviews and recommendations identified causes for the financial increase and a detailed view of what was driving the demand for one-to-one care.
It also explored one-to-one care delivery in line with the individual contract agreements and one-to-one packages, compared these to the health needs of the individual, and identified area where the care contracted and provided was not required by the patient.
The Outcomes
Liaison Care reviewed 34 cases and made recommendations for reduction of one-to-one care in 25 of these, detailing the primary cause for the financial increase and overspend within OCCG. In these cases, one-to-one care was not core to the clients’ needs.
The reviews highlighted no safeguarding concerns highlighted as part of the review.
100% of cases identified an appropriate initial assessment of need for one-to-one care.
The reviews highlighted no safeguarding concerns highlighted as part of the review.
There were 13 cases where assisted technology was recommended to help reduce one-to-one care, suggesting a potential gap in staff awareness of the solutions on offer which could be improved on with training.
Finally, there was a significant difference in expenditure of one-to-one care across the care providers which had been agreed by OCCG. The variation in costs was attributed to a difference in hourly rates, meaning that our recommendation of reviewing and aligning this could save the CCG over £4,000 every day.
Next Steps
In the short term, Liaison Care have recommended a review of the remainder of one-to-one cases across the Oxfordshire locality, to ensure consistency and to confirm the least restrictive practice is present.
In the longer term, Liaison Care has recommended a review of the process for agreement and monitoring of one-to-one care, and potential training needs across the care providers.
We have also recommended the consideration of a standardisation or cap on hourly one-to-one rates to reduce financial variability.
Talk to our Experts
To discuss how Liaison Care’s reviews could support your organisation or system
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Business:
Oxford CCG
Challenge
Overspend on one-to-one care
Solutions
Bespoke Consultancy (one-to-one reviews)