How the ‘gig economy’ could revolutionise social care

By matching self-employed personal assistants to direct payment holders, online technology could transform the care market

By Matt Bee

How you receive parcels in the mail could revolutionise how you receive care in the community. And it all comes down to something that’s been in the news a lot of late – the gig economy.

The gig economy is the idea that workers seek employment on a day-to-day, job-to-job basis. In the digital age it’s simple. You sign up online, state what hours you want and the work you’ll do, and the website matches you to available roles. But it’s more than a simple jobs site. These aren’t even jobs as such; just tasks that need doing, one at a time, accumulating payment as you go.

Software developers, marketing consultants, accountants and even writers all find gainful employment this way. But where the idea has really taken off is in the world of couriers.

Rise of self-employment

Here, millions of parcels are pushed through letterboxes daily, each earning the courier a small fee. Effectively this is classed as self-employment, and, as such, you can see how the trend has really taken off. Since 2008 the numbers registering as self-employed has risen from 13% to 15% of the UK job market from 2008-15. At 4.6 million workers, soon their number could exceed those employed in the public sector. Part of this is down to the flourishing gig economy.

Supporters of this way of working point to the flexible hours, freedom and choice as a real boon for the worker. But, critics counter that the whole thing is actually just a sneaky way for large firms to circumvent employees’ rights, since, technically, there are no employees, just contractors. What that means in practice is something hotly debated, including in the courts, right now. Drivers for the private taxi hire firm Uber recently won their case to be considered employees, rather than self-employed, for the most basic of rights, such as holiday pay, sick pay and the minimum wage.

But it’s what this could mean for the care sector that’s most intriguing. With the launch of a few clever apps it could literally turn the industry on its head, transforming agency carers into freelance personal assistants at the tap of a smartphone screen.

Horror or hope

That might fill you with horror, the idea of a largely unregulated workforce descending on the homes of vulnerable people. Or, paradoxically, it might actually fill you with hope.

After all, with the way things stand at present, if a service user wants to recruit a personal assistant outside an agency they’ve little option but to employ directly – which means managing holiday pay, sick pay, pension plans, national insurance, tax payments, training needs, the whole caboodle. And if it doesn’t work out, they’ve got to handle disciplinary action, written warnings, or giving someone their notice.

Yes, there’s support out there to help with this. But wouldn’t it be easier, wouldn’t the prospect of having a personal assistant hold much more appeal, if you could dispense with this side of the arrangement altogether?

And with that, could we see a significant shift towards people receiving direct payments rather than council-managed personal budgets, transforming the care marketplace.

Glimpse of the future

A possible glimpse into the future comes from HomeTouch – one of the first online platforms in the UK for personal assistants to advertise as self-employed workers, and for service users to hire them.

Set up in 2015 by dementia physician Dr Jamie Wilson, it’s a quick and easy way of finding support. Or at least that’s what HomeTouch’s PR spokesperson says when I speak to her. She directs me to the independent review site, TrustPilot, where customers have rated the service 9.4 out of 10 and left an abundance of glowing comments.

How far this is a reflection on HomeTouch as an organisation, and how far a reflection of the working model that underpins it, is impossible to say. But what is clear is that this could signal big changes ahead.

So far, 350 carers have successfully registered with the site, with HomeTouch saying many more have applied but failed to get through their vetting process. Meanwhile, other similar platforms are springing up – enticing care staff away from the zero hour contracts and poor pay that many mainstream agencies have to offer.

Lack of regulation

That means the future could be bright if you’re a service user looking for a PA. Or it might be bleak for the staff concerned, if you consider what has already happened in the world of couriers, many of whom complain of being grossly exploited. And then there’s the thorny issue of regulation. As things stand, it’s unclear how the Care Quality Commission can oversee online platforms or the carers finding work through them. Neither has to register with the inspectorate.

What is clear, though, is that the gig economy could be on the cusp of transforming the care sector – for better or worse. Not for nothing has it been dubbed the ‘Wild West Workplace.’ But, at the same time, through the promise of hassle-free hiring, it may make the notion of direct payments a great deal more palatable. Hiring a PA instead of employing them could ultimately be what service users want. If it is, this idea looks set to take off.



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9 Responses to How the ‘gig economy’ could revolutionise social care

  1. Jamie Wilson November 7, 2016 at 2:59 pm #

    Thank you for covering HomeTouch in this article, but I’d like to address a number of misconceptions that have may have arisen from above.

    Firstly, the whole basis on which HomeTouch was founded was that carers were being underpaid in the care sector, which has led to high staff turnover, lack of continuity with clients and ultimately inconsistency and lack of reliability for service users/patients. Our model allows carers to set their hourly income and negotiate this with private families or people receiving direct payments/personal budgets. This leads to a dramatic increase in hourly income, on average at least 28% higher than the London Living wage. We are also approved by the Living Wage Foundation.

    We have published data recently which can be viewed here.

    Secondly, the idea we are shying away from regulation is false. We would welcome regulation and scrutiny, but like many forms of innovation the regulator is slow to catch up.

    Thirdly, we operate far from the exploitative practices of some courier companies where workers receive piece rates at below minimum wage. In fact, our who ethos is helping experienced care workers maximise their earnings, providing continuity with clients and allowing them to enjoy their vocation with better working conditions.

    Fourthly, we risk assess both clients and carers who use our model. It is correct to say that not all care workers are suitable to work on a self employed basis, which is why we approve only 5% of applicants.

  2. Martin Stevens November 8, 2016 at 11:49 am #

    Very interesting piece, but I think this is a worrying development. Workers employed by agencies have rights (although these are fairly minimal as it is). It is only through these rights that issues such as payment for travel time between calls for home care workers are being addressed. Introducing this sort of spot hiring systems could well mean a serious reduction in working conditions for care workers, whose conditions are already pretty poor. Ultimately, this is going to have a knock on effect on the quality of PA provision for direct payment users. People with no security of employment, holiday or sickness pay, are unlikely to work in the emotionally committed way required to provide good support. The interests of workers and people needing support should go hand in hand and this kind of approach is very clearly not in the interest of care workers.

  3. Arturo Sensi November 8, 2016 at 1:24 pm #

    I genuinely do not know how to express my horror at the endorsement of this nonsense.

  4. Sally November 8, 2016 at 1:48 pm #

    This is a really interesting article and real food for thought. It would certainly address the issue that many adults have in terms of finding a Personal Assistant locally. Local Authorities have been slow to respond to residents requests for a PA Directory type service which has caused much frustration and sadly led some people to ‘give up’ on the whole idea of a PA. Instead, many feel they have no other option but to use traditional agencies or services commissioned through the Local Authority. This is extremely limiting in terms of delivering personalisation and supporting people to live fulfilling lives that they control. I do wonder thought what the response would be from Local Authorities and whether they would be happy for a Direct Payment to be used to purchase PA support this way? Also, how accessible is the service in terms of being equally easy to access for all?

  5. JP November 9, 2016 at 2:20 pm #

    Isn’t this just another example of a zero hours contract?

  6. Jamie Wilson November 9, 2016 at 2:30 pm #

    Some of the comments above show frankly a unwillingness to think beyond their own narrow world view and ultimately are doing the vulnerable people they purport to serve a disservice.

    How can it be a “worrying development” when people who can not ordinarily access care through agencies (and are often left in distress, discomfort or simple isolation as a result) are now easily able to find a resource where there are well remunerated, motivated and committed care professionals immediately available to help with their needs.

    The insinuation that committed, compassionate people who are perfectly able to make choices about how they work are being herded into a precarious existence is pure fantasy. If carers working through HomeTouch felt that way, they would vote with their feet and find work elsewhere. The reason they don’t and the level of commitment and consistency is higher, is because the model is closer to the Buutzorg model in the Netherlands where freedom, professional autonomy and community spirit take precedence over less important considerations such as how much holiday pay can you store up.

  7. Blair McPherson November 9, 2016 at 5:00 pm #

    We used the ,” gig economy ” model when I was seeking someone to walk my dogs a couple of times a week and look after them when we went on holiday! We did find some people unsuitable but are very satisfied with the person currently undertaking the task. May be they could support my 88 year old mother in law.

  8. Ellie November 10, 2016 at 1:45 pm #

    Interesting article, and, rightly, it should spark some interesting debate.

    I can see both sides of the argument, here, and it would be fascinating to know just to what extent the proposal that we utilise a “gig economy” model for hiring personal carers has been thought through?

    On the plus side, I can see immediately that it would be a benefit for service-users, who could quickly access care which otherwise they might have to wait for. If websites existed where carers could sign up, and await contracts, then obviously there would be a centralised resource for service-users to access – one that collects together vast numbers of potential providers of care. This would clearly make it much quicker for service-users to locate and hire personal care assistants. IT also eradicates the problem of an individual service-user on PIP having to become, in effect, an employer. There would no longer be a need for said individual to have to negotiate a contract, pay, holidays, holiday cover, insurance…

    There could, as argued, be some benefits in it for carers, too. They would be permitted greater flexibility in respect of working arrangements – based on ability to pick their own working hours. This could clearly appeal to people who want to work part-time because of, say, childcare commitments; or people who are fitting work around study commitments. Models such as the one mentioned already exist for other professions – in teaching, for instance (tutors can sign up to online sites that they leave their CV with, and which allocate them work according to whether it matches up with what the tutor says they want to do). I note the same applies to computer programmers, writers, accountants, marketing consultants… I guess it’s what we might call “FREELANCE” work.

    Which leads to the cons…

    Some people are probably content to work as freelancers – but this cannot be said for all. Freelance work is something analogous to acting. And we all know the old jokey saying about actors…
    “What is an actor whilst he’s waiting for an acting contract? A waiter!”

    My point is that, if a person works in this way, then questions do exist about rights and entitlements. Just what does happen in respect of sickness absence, or holidays? IF workers are not seen as employees, but rather as freelance contractors, then there IS the issue of their not getting sick pay, annual leave and other workers’ rights. This clearly leads to an ethical and moral dilemma.

    Another problem is the issue of just how one goes about regulating the standards of such employees. If they are simply to list themselves with a website, or app, then who is it that has overall responsibility for important checks – such as checking academic qualifications, checking they have not lied on their CV, checking CRB clearance and so forth? This is particularly important when we are talking about personal care assistants, who may be working with vulnerable, sick or disabled adults and children. If there is no way of effectively checking credentials, then just where is the comeback if a service-user ends up employing, heaven forbid, a paedophile or a fraudster? There MUST be some way of ensuring that adequate checks are put in place. The problem with websites and apps is that people using them are strangely “anonymous” – do we really know if they are who they claim to be? Because the internet developed with little regulation, it has become a hotbed for fraudsters, confidence-tricksters, paedophiles… These people can easily go online and pose as someone they are not. Even non-criminals find it ever so much easier to LIE online. Just look at social media – people post airbrushed photos, make claims and boasts about things they are doing (that they have never really done). Psychologists know that it is a common phenomenon for people to over-inflate their online persona, and to make themselves seem online more impressive than they really are. I have a personal example…

    There was a woman (K) who studied Social Work at the same time as me. She is currently online using “LinkedIn” to advertise her CV. In this CV she claims to have qualifications and skills in child and adolescent Psychology. I know for a FACT that she has NEVER studied Psychology, or child and adolescent Psychology, in her life. So, she is LYING on her online CV. Oh! And being a mother DOES NOT give you a qualification in child psychology! The problem is that, unless somebody on the website chooses to check a registrant’s claims out fully, people can go online claiming all manner of skills and qualifications (which they may, or may not, have).

    The above could, as I pointed out, be disastrous in respect of service-users hiring personal care assistants. Lack of accountability could make the whole issue very risky. After all, just WHO is the employer (if any)? Who is the employee (if they are even considered an employee) ultimately accountable to? How does a service-user raise a grievance if something goes wrong? Or, how does a worker raise a grievance if something goes wrong?

    Seems to me the crux of the matter hinges around the CONTRACT – just what is drawn up, by whom, and what does it imply?

    I guess this is a “food for thought” article, and there are issues that definitely warrant exploration. Whilst it is clear that our world is changing, and that this means considering new ways of working, it also means that we should fully consider the implications before entering into any new arrangement.

  9. Arturo Sensi November 10, 2016 at 5:09 pm #

    Oh dear Jamie Wilson, no doubt learn to get on my bike.