Recently I noticed a couple of reports highlighting the impact of tremendous inconsistency in the awarding of NHS continuing care funding to people across the country.
It seems to be the other type of postcode lottery. Not the one on TV.
For those that don’t know, and by all accounts that’s quite a lot of us, NHS Continuing Care Funding is available to people with complex healthcare needs to pay for the care and support they need, and unlike Adult Social Care services, is free.
According to Healthwatch England and the Nuffield Institute there is unacceptable variation and poor experiences reported by people who apply for funding. This is in the context of decreasing levels of spend despite increases in need.
So much for the “travelling in hope” moment I mentioned last time.
Well, I can report I still am, but as the saying should go, “you hope for the best but then you plan ahead and work bloody hard for it too!”
I noticed the report headlines because now is the time of year we plan and prepare for the many conversations and negotiations needed to confirm how much each of our Local Authority and NHS contract partners will pay us for providing their services next year.
I’m sure it’s something they look forward to as well.
During this preparation, I have been known to get distracted by the whole system issues and big headlines about NHS and Local Authority funding from central government, the national allocations, the specific grants and the money that can be raised locally for example through retaining business rates and income from council tax.
It’s tough out there and I have a lot of respect for the people in statutory services that need to make the sums add up.
We’re talking big numbers with bold statements about what the money should be focussed on, for example the guidance and instructions on the Better Care Fund.
But over the years I have found the two things most effective in influencing any negotiation are both found in the smaller details of our services - How we use public money and what difference we make.
So Medequip works very hard to make the most of every penny it gets from the public sector and to listen to the people who use our services when they tell us what impact we have had.
That approach provides some consistency, because there's a huge variety of wording in contracts to cover inflationary increases. There's also a wide variety in the types of negotiation process that follow.
This ranges from, I'm sorry there is no increase in the amount we are paying you this year and no process for discussing this, to full transparency on both sides and a laser-like focus on agreeing how to make sure the service works for people and that Medequip is funded fairly.
However interesting I find the wider context, in my experience it’s the local details that will really help the negotiation. That’s why however large Medequip becomes I know we will always be embedded in local communities.
So, whilst I’m sure I’ll continue to be distracted by the big money headlines in health and social care, this is the time of year to really get under the bonnet and get to grips with the details.