Income maximisation in Adult Social Care

Funding for Adult Social Care (ASC) has been a hot political topic for several years. With funding reforms shelved yet again, and budgets getting increasingly stretched, councils are having to look hard at how they maximise the income they receive for ASC, both from people who pay for their own care, and from the NHS. The level of people required to make service user contributions has been increasing in recent years. However, inefficient processes, silo working, and a culture which discourages conversations about finances have led to many councils struggling to secure income.

Getting this wrong doesn’t just impact the financial position of the council; it results in poor customer experience for people using services. Many people report confusion and worry due to lack of transparency and communication around charging. In one council we recently worked with, more than 10% of calls to ASC were from people worried about invoices or charging letters they had received.

Pursuing that income effectively is necessary, but it needs to be done in a way which doesn’t undermine attempts to build effective relationships with people, or that discourages people from accessing support that could prevent crisis further down the line.

Equally important is securing contributions from Health. Many individuals with long-term conditions or complex needs receive support across both ASC and Health, yet there remains a disconnect in financial contributions. Councils are often left bearing an undue proportion of costs, which could be mitigated through more robust partnership arrangements.

Key to tackling these challenges and maximising income is a holistic approach; working across the system to change process, policy and behaviour. Councils can’t approach income maximisation in isolation: the approach taken will impact on local relationships and shape behaviours of people and partner organisations, so needs to demonstrate fairness, transparency, compliance, and making the best use of resources.

Through a recent project working with a council to improve customer journeys, IMPOWER identified five steps to support income maximisation.

1. Understanding the need for change
   It’s essential to recognise and share why changes are being implemented, sharing the message internally and with the public that charging is one way to ensure that individuals receive the care they need while maintaining quality of services. It’s crucial to highlight how these charges contribute to improved care quality and access to resources.
2. Increased transparency
   This means developing clear and consistent policies and processes that are shared with clients and family members from the outset. Transparency in how charges are determined and allocated is vital. When people see where their money is going, they are more likely to feel comfortable with the charges. Detailed breakdowns of costs, along with clear communication about service levels, can build trust and understanding.
3. Improving processes
   Often, charging and financial processes are convoluted with handoffs spanning across services and do not make the most of digital solutions. In recent work with one council, IMPOWER focused on bringing together finance and ASC teams to remove silos and make processes more intuitive, re-designing them from the customer – rather than system – perspective.
4. Encouraging behaviour change
   IMPOWER has utilised Applied Behavioural Science methods to re-design communication around charging with several councils. Through making small changes to language, tone and layout of communications, councils have been able to ‘nudge’ people to increase the timeliness of payments.
5. Tracking the metrics
   Income maximisation is often an area that is overlooked in ASC financial plans. Undertaking trajectory modelling to understand the potential impact of securing income, and tracking performance against this, will support councils to ensure they are maximising all income streams to support a sustainable service for the future.

If you would like to discuss IMPOWER’s work in Adult Social Care further, please get in touch.