Use CareCubed to assess uplift requests

Local authorities are struggling to cope with high volumes of extraordinary uplift requests for the cost of care, but the good news is that the independent care pricing tool CareCubed offers a quick and fair solution.

How to deal with the unprecedented number of uplift requests is a problem being faced by all councils which commission care. Providers are now frequently asking for more than the standard annual inflationary increase applied by many local authorities, citing extraordinary circumstances such as the cost-of-living crisis. This leaves local authorities with many questions such as: How can we assess this request? How do we know if it is fair and reasonable? How should we respond? What evidence base can we use to challenge?

Historically, many local authorities would have negotiated the proposed increase down slightly or perhaps agreed to meet halfway. With the help of CareCubed, councils are being able to tackle these requests fairly and in a way that helps direct their limited funds to the providers which really need it.

Some local authorities, such as Surrey County Council (SCC), are using CareCubed effectively for uplift requests by embedding CareCubed into their processes. When requests come in that are above the usual inflationary uplift, providers are asked for more detail and the case is then run through CareCubed. “It is how we decide whether to agree to an uplift or not – it gives us an evidenced-based way to do that and quickly make a decision. This has allowed us to control our costs very effectively where these requests would have previously been accepted as there was no evidence base or benchmark to compare against,” said Nikki Browne, Contract and Commissioning Manager at SCC.

The data which powers CareCubed is drawn from a variety of independent sources to ensure it is accurate and reliable. This allows the tool to benchmark the cost of care for a particular service. iESE updates the tool frequently and more often when necessary because the data accuracy is critical to control spiralling costs and to create a fair and sustainable market. For example, inflation figures built into the most recent interim update included an increase of more than 50 per cent for utilities and 10 per cent for food compared with March 2022. Some requests received from providers have been considerably higher than the data suggests they should be, but CareCubed allows local authorities to do a ‘reality check’ on costs given against what the tool calculates, giving an evidence base to start negotiations.

In one recent case, SCC were asked for an extra £2,000 per week for a single placement in a six-bed setting. The provider was asked to provide a month’s worth of care logs detailing spending, care given and staffing levels. Drilling down and comparing costs to the CareCubed guideline benchmarks found the provider had included items which were not considered reasonable, including a high spend on takeaways, high head office costs and items such as parking fines. As a result, an increase of an extra £200 per week was agreed instead of £2,000.

Craig White, Head of Business Development at iESE, said some local authorities currently assess uplift requests through their own spreadsheet models, but explained that part of CareCubed’s power was in its independence. “Where uplifts are contested, it is not the local authority saying the amounts are too high, it is CareCubed and the vast amount of data that underpins it that says it is too high. The tool is recognised by providers and commissioners as being a best-of-breed tool which gives an easier starting point for negotiations and opens up a different, more open, transparent dialogue between provider and commissioner.”

He also points out that while CareCubed might identify cases where the requested uplift is beyond expected, the tool also helps sufficiency by highlighting where providers are not charging enough. “From a governance and a cost control point of view CareCubed is really powerful, but it is not just about drilling costs down, it is about making sure councils are directing their limited funds in the right way and, equally importantly, where some placements are underfunded, ensuring they can be increased so providers can keep their doors open,” he added.

White said applying across-the-board annual inflationary increases might start to give way to considering each placement individually – something CareCubed can do much quicker than has historically been possible. He points out that the issue of applying an increase to all indiscriminately is that the gap between overfunded and underfunded increases, whereas councils ideally want to bring all providers into line. “Most councils offer an inflationary annual increase to providers, but this can result in already overfunded placements getting a larger real term increase than unsustainable legacy placements. CareCubed will quickly assess and benchmark each case so that shrinking budgets can be directed to those that really need it. Using CareCubed, especially the place-based licence which allows providers to input their costs directly into the tool in a standardised way, reduces data entry time and makes assessing uplift requests on a case-bycase basis much quicker than has previously been possible,” he explained.

White said many new CareCubed customers were keen to immediately use the tool to handle their uplift backlog: “There is an immediate need with massive potential returns in terms of limiting the impact that these requests have. CareCubed is being used creatively in so many ways now, covering both tactical day-to-day uses and strategic, marketshaping projects such as designing new services and re-commissioning, but for many this influx of uplift requests is a firefighting exercise and one which CareCubed is well equipped to help with,” he added.

• iESE hosted an uplift workshop in March 2023 with Surrey County Council. To find out more about the event or more about using CareCubed for uplift requests contact: craig.white@iese.org.uk