Delivering the grand design

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Delivering the grand design
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Contents

• Looking at personalisation
• 3 customer groups
• Its all about value
• Growing your business without limits
• Some observations on residential and nursing care
• Building a successful social care business

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Looking at personalisation

• Personalisation is in part about a transition to
  a tariff based system where the main currency is
  hours.
• Personalisation is about a systematic reduction
  in funding allocated to individuals
• Currently personalisation does not mean much in
  relation to residential and nursing care but
  this will change
• Personalisation is an idea or value for people
  with services funded by the NHS, but not a
  structural change - yet

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3 Customer groups
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• People who have a direct payment and commission
  their own services
• People who could qualify for a direct payment but
  choose the local authority or another to
  commission their services
• People in residential or nursing care who do not
  qualify for a direct payment

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3 Customer groups
60m

• People who have a direct payment and commission
  their own services
• People who could qualify for a direct payment but
  choose the local authority or another to
  commission their services
• People in residential or nursing care who do not
  qualify for a direct payment

1.3b
1.5b
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3 Customer groups
How quickly will it grow?

• People who have a direct payment and commission
  their own services
• People who could qualify for a direct payment but
  choose the local authority or another to
  commission their services
• People in residential or nursing care who do not
  qualify for a direct payment

How quickly will it shrink?
How quickly will it change?
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Its all about value

• Myths of personalisation
• People will be willing to pay a higher hourly
  rate for a more professional service
• Personal Assistants represent a viable
  alternative form of support for the majority of
  people with a learning disability
• Small informal organisations driven by their
  values are always better at providing services
  than big organisations with systems and
  infrastructure

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Its all about value

• Myths of personalisation
• People will be willing to pay a higher hourly
  rate for a more professional service
• Personal Assistants represent a viable
  alternative form of support for the majority of
  people with a learning disability
• Small informal organisations driven by their
  values are always better at providing services
  than big organisations with systems and
  infrastructure

No evidence to support this assertion. What
evidence does exist suggests the opposite.
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Its all about value

• Myths of personalisation
• People will be willing to pay a higher hourly
  rate for a more professional service
• Personal Assistants represent a viable
  alternative form of support for the majority of
  people with a learning disability
• Small informal organisations driven by their
  values are always better at providing services
  than big organisations with systems and
  infrastructure

Currently around 80,000 PAs across all clients
groups
Are there another 125,000 people per year who
just want to be PAs for people with a learning
disability?
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Its all about value
Ideology is not evidence. Good and bad
organisations come in all shapes and sizes

• Myths of personalisation
• People will be willing to pay a higher hourly
  rate for a more professional service
• Personal Assistants represent a viable
  alternative form of support for the majority of
  people with a learning disability
• Small informal organisations driven by their
  values are always better at providing services
  than big organisations with systems and
  infrastructure

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Its all about value

• Research amongst people who use services
  indicates that
• Service volume is key i.e. more help the better
• Price per hour will be very important
• Qualifications/ quality assurance/ HR systems etc
  much less important
• Personality of specific workers seems to be the
  single most important factor

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Growing your business without limits

• Personalisation means an end to a local authority
  managed market of community services
• Personalisation means the creation of an open
  market for community services
• Expect endless variations on the theme of trying
  to wrest back control from customers
• As providers you want the customer to be king

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Growing your business without limits

• Organisations need to manage the transition from
  B to B to B to C
• Different areas move at a different pace
• Need to be alert to opportunities for growth
  based around direct sales to the customer and
  their family
• Everyone using community services is a potential
  customer all of the time
• This means all your customers too

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Growing your business without limits

• Personalisation means an end to a local authority
  managed market of community services
• Personalisation means the creation of an open
  market for community services
• Expect endless variations on the theme of trying
  to wrest back control from consumers
• As providers you want the consumer to be king

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Observations on residential and nursing care

• Residential and nursing care is becoming the
  unacceptable face of social care provision
• Nationally commissioners state publicly their
  intention not to buy this type of provision
• The facts appear rather different.

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Local Authority commissioning
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Residential and Nursing Care

• At the present time the residential and nursing
  care market has not collapsed
• The nursing care market appears to a steady state
• Residential care brought by local authorities is
  declining but not quickly
• Unclear if market shift is the result of provider
  or purchaser driven action
• Appears to be viable model for at least the next
  10 years

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• Characteristics of successful organisations

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CB Characteristics of successful future
organisations c.2008
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CB Characteristics of successful future
organisations c.2008
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Future losers

• Change resistant
• Still believe they know best (or better than
  their customers)
• Brand free (no one has ever heard of them)
• Think that they can carry on selling the same
  things
• Believe that price is not the issue
• Continue to focus on commissioner driven
  quality standards over customer driven standards
• Just dont get it

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Who will the futures winners be?

• Strongly branded organisations with a capacity to
  deliver on business to customer relationships
• Huge focus on continuously raising customer care
  standards
• Clear customer-valued offer on attractive and
  competitive terms

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Who will the futures winners be?

• Clear internal resolution of values vs. customer
  wishes conflicts
• Clever application of technology to maximise
  benefits to customers and minimise staff use
• Capable of consistent and purposeful outcome
  driven delivery

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Conclusion 4 points

• Now is the time to fix it dont wait for it to
  be broke
• A window of change exists but it will close
• You need to choose now if you are going to
  flourish or wither to do nothing is to choose
  wither
• Get used to it

The customer is always right