SCC Fee Uplifts on LD Contracts

11 Apr, 2018

Comment from David Holmes, SCA Chair on SCC Fee Uplifts on LD Contratcs

Surrey County Council mailed letters to Surrey LD Providers on Monday 26 March to communicate information about fee uplifts for 2017/18, 2018/19 and beyond.

In broad terms SCA welcomes these uplifts. After several years of slim pickings we are grateful that SCC has once again instigated annual fee increases for LD services in Surrey. It is clear that without the robust approach brought by the provider community these uplifts would not have been secured.

We note the following specifically as positive developments:

  • SCC and SCA have worked effectively together as partners through the Cost of Care programme, which has precipitated these uplifts. We are grateful to Ann Kenney for Co-Chairing the Steering Group, to those providers (including our own SCA Director, Graham Elliot) who participated in the Steering Group and to all members for their participation.
  • The Cost of Care programme has confirmed that the LD sector is underfunded and that without remedial action sustainability is at risk.
  • The Cost of Care programme and subsequent deliberations about these uplifts have raised the issue of LD funding up the agenda at SCC. It is now a salient issue.
  • Mel Few, Helen Atkinson, Brian Mayers and others have put themselves out to fight our corner within the Council. We are grateful for this.
  • SCC has acted honourably by granting a fee uplift for 2017/18, even though this period is about to end. This will provide a much-needed cash injection for many organisations.
  • Given the passage of time it is helpful that the uplifts for 2017/18 and 2018/19 are not contingent on current fees and costs. We confirmed this understanding with Helen Atkinson at the recent Provider Network meeting. The likelihood is that for the periods 2019/20 and beyond the price and cost structure for each service will be taken into account in determining uplifts individually, but this is not unreasonable.
  • SCC has recognised the need to improve funding for sleep-ins, which will reduce the need for top-ups and thereby enable averaging to work more effectively.
  • SCC has committed not to implement rebates for 2018/19. This is relief to all of us who remember the dark, misguided days of the High Cost Placement Review. We hope that ongoing work with SCC will lead this to be relegated to the past, once and for all.

There are, of course some aspects of the communication which cause concern. These include:

  • The proposed shift from 8 to 9 hours for a sleep-in.
  • The ambiguity about the statement that payments will be made ‘as soon as the pricing model has been completed and agreed.’ We believe that that ‘agreed’ means ‘completed correctly.’
  • That the workload created by providers submitting cost models will be unmanageable for SCC, and that this will delay uplift payments.
  • That failure to submit models by 29 June 2018 should not result in non-payment of uplifts. Most providers will endeavour to meet this deadline, and those who cannot will have good reason.
  • The implementation of schedule payments for supported living without greater thought and consultation. At the very least there needs to be an evaluation of the cashflow impact on providers.

We have suggested that SCC should take two actions in the immediate future:

  1. Estimate the value of the uplift for 2017/18 and make payments on account to all providers. This will avoid the inevitable delay to these payments and the pressure that would create.
  2. To balance the setting of a deadline for submission of models SCC should commit to deadline for the payment of uplifts.

Beyond these steps, we will continue to work with SCC an all future related matters. There is still work to be done to secure all desired outcomes from the Cost of Care programme and we are keen to progress work on the Quality and Performance Framework. We hope that this will lead us to focus on the quality of outcomes rather than the cost of inputs.

Reflecting back on the uplifts, what we don’t know is quite how these uplifts will affect the longer- term sustainability of the LD sector as we suffer inflationary pressure and yearly increases in the NLW. Have they provided the solution or just kicked the can down the road? We have an inkling that there is more to be done.

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