You will have seen Lord Darzi’s Independent Investigation of the National Health Service in England this week. It made for sobering reading as he surmised that the NHS was in a critical condition. That’s an assessment many have made themselves over the past years, despite everyone’s hard work to change services for the better.
But rather than simply make criticisms, Lord Darzi also set out a ‘treatment plan’ to get the NHS working again. And there was one element of his diagnosis and plan that we at Alocura were not just encouraged to see but can help you with right now. Digital transformation of care provision.
“The NHS is in the foothills of digital technology… parts of the NHS are yet to enter the digital era,” said Lord Darzi. And unfortunately, given our work with care commissioners and providers, we know this to be completely true.
We are 20 years into the personalised care agenda and commissioners are still asking for bank statements and paper trails to audit budget expenditure.
Where other sectors of the economy press ahead with AI and digital administration to transform their businesses, anyone auditing packages of care knows full well that they will be wading through piles of A4 paper, making sense of bank statements, invoices, receipts, liability certificates, hand-written timesheets and employee details.
These are most of the reasons we set up our pioneering cloud-based care management system Rostrata in the first place; the process for planning, administering and managing care out of hospital settings was literally all over the place, for everyone.
The other reason was that Alocura also manages complex budgets in a third-party capacity – so we knew from experience that we needed a system ourselves that could give us true oversight.
And that experience means we know that just one in ten packages are requested for audit each year from the NHS PHB Auditors. Replicated market-wide, that is a significant problem – or at least it should be – for NHS commissioners. Frankly, they have no idea how the budgets are being spent on 90 per cent of the packages of care they fund. At a time when finances are at breaking point, let that sink in a little!
We want to peel back the curtain still further. We were asked by the NHS PHB Auditor for an audit last week on a package under our care. It asked for five years’ worth of the information and evidence to be supplied within seven days. We could do this because we have developed the digital system – Rostrata – to output all the necessary reports at the click of the button. But their request provoked so many questions.
- Why are auditors not on top of this information on a yearly basis – what does that say about the ongoing oversight commissioners have – or more pertinently don’t have?
- Secondly, how would a hard-pushed care provider or even family cope with being asked for this information without our system? Quite frankly, they can’t – so if any undue or misspent expenditure was discovered the chances of recovering that money would be next to zero.
So yes, it is costing the NHS and local authorities an enormous amount to audit less than 10% of personal budgets, putting huge pressure on families and care providers in the process. We can’t think of any organisation who would consider this remotely efficient or effective under any circumstance. But with an open-book arrangement with a care provider using Rostrata, anyone could audit any package at any time.
Back to Lord Darzi’s report for a moment.
“There must be a major tilt towards technology to unlock productivity. In particular, the hundreds of thousands of NHS staff working outside hospitals urgently need the benefits of digital systems.”
Yes, he’s talking about NHS staff in particular. But a wider point is revealed here in terms of the digital systems necessary to operate every element of the care process in out-of-hospital settings. Sound unattainable? This is what Rostrata can offer. From care planning to rostering staff, care delivery to automated payroll, invoicing and finally auditing, installing Rostrata means everyone from a personal assistant to a team leader, a care provider CEO to a care commissioner, has immediate access to everything required to ensure that package of care runs effectively and productively. And it can be monitored and assessed at any point – not just every five years.
Lord Darzi again:
“The problem is that to provide high-quality, multidisciplinary care in the community requires resources that often are not there. These include the right professionals with the right skills… and digital infrastructure… to support them.”
With Rostrata, the digital infrastructure to underpin care in the community is already there. And because Rostrata reports by exception, comparing budget expenditure to the care and support plan, auditors only really need to focus on problems – which they can do in real time rather than five years later. They’d never need to recover money again, because using Rostrata it wouldn’t be unknowingly spent in the first place.
And yet, 20 years into the personalised care agenda and commissioners are still asking for bank statements and paper trails to audit budget expenditure. No wonder Lord Darzi is asking for change.
With Alocura and Rostrata, you can begin that journey of transformation today. If you are a commissioner or provider, get in touch with us today.