Local authorities have set up online e-markets to meet key duties under the Care Act but their potential to deliver choice to care users could be undermined by risk aversion from frontline staff and management, according to a report.
Research by the Institute for Public Policy Research (IPPR) think-tank found that around a quarter of councils now allow self-funding adult social care users and personal budget holders to search for and purchase care services via ‘Amazon-style’ e-markets. Many had set up the sites to meet their responsibility to provide universal information and guidance under the Care Act 2014, the IPPR said.
Benefits of e-markets
The IPPR identified three main benefits to the e-market systems: they improved access to the market for new and small providers, provided more opportunities for user-commissioning by allowing people to describe the service they want and providers to respond with a tailored service and price, and helped integrate networks of formal and informal care.
However, the report also identified a number of issues with implementation of the platforms. Too many local authorities viewed them as cost-saving tools rather than a chance to transform care. A culture of risk aversion among local authorities and frontline staff often stifled new providers from entering the markets and led to professionals and brokers directing people to services they had always used.
Culture change
“Action is required in a number of areas if the genuine choice that e-marketplaces promise is to be delivered. First, those who help users to select products and services need to become confident in helping those users find the services that are right for them, rather than simply directing those users to the services that the broker or social worker has always used,” the report said.
“Many of the most innovative providers are non-traditional, and substantial offline work and cultural change among staff may be required to ensure a diverse supply rather than a replication of the existing market. Carers, paid brokers, frontline social workers and charities with advisory functions all assist users in making choices, and they are key to this process.”
The culture of excessive caution must be tackled by ensuring that risk is shared appropriately and frontline staff are given the attention and permission they need to focus on outcomes rather than being “cowed by concerns about compliance and liability”, the report said.
The report pointed to Worcestershire county council as a good example of a local authority supporting its social workers to utilise the new system. The council held networking events for social workers to meet local care providers and discuss the e-marketplace.
Wider potential of technology
The e-marketplace model is just one example of how local authorities are looking to use technology to meet their Care Act duties. The most recent Care Act stocktake by the Local Government Association and the Association of Directors of Adult Social Services (Adass) found that 147 of 152 local authorities planned to introduce an element of online self-service for care ranging from e-marketplaces to web-based assessments.
Richard Pantlin, the Adass technology and informatics lead, said directors were keen to promote online options for individuals and carers who were “happy and capable to use it”.
“Hard-pressed people in their 40’s, 50’s and 60’s who are the main informal carers for their elderly parents will find such resources particularly helpful. Many more are likely to be contacting councils as a result of the cap on care costs being introduced from next April,” he said.
“During this year, Adass is organising workshops in each of the regions to encourage more co-operation across councils and to share best practice for engaging citizens online for the Care Act. Many councils have already implemented good Information & Advice portals that direct users according to their needs.
“Some, such as Oxfordshire, have enabled carers to complete their own assessments online. Others are planning online financial self-assessment. There are also an increasing number of apps independently available to people in need of support and their carers to assist them.”
Adass is holding a ‘Care apps showcase’ on 19 October in Leeds.
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