A Mindset Shift Towards Outcome Based Social Care

We strongly agree with Mr. Streeting’s sentiment and echo his call for a mindset shift in the way we approach healthcare/Adult Social Care delivery. Our ultimate holding company, based in Singapore, reinforces our commitment to prioritising outcome delivery, emphasising the importance of shifting the focus from rigid time and cost, dare we say, warehousing model to a more holistic approach that centres on person centred outcomes.

Our approach aligns closely with the Singaporean model, emphasising the following key elements:

• Data-driven Decision Making: We place a strong emphasis on collecting and analysing data to inform our strategies. This ensures that our interventions are tailored to the specific needs of each service user, fostering a more personalised and effective care experience. This is undertaken by our in house PBS Practitioners and Behavioural Analysts.
• Embedded Positive Behaviour Support (PBS) Service: Our commitment to reducing challenging behaviours is facilitated by our embedded PBS service. By addressing the root causes of these behaviours, we aim to create a supportive environment that promotes positive outcomes for service users. This is achieved by training all our staff in PBS and trauma informed care designed and delivered by our inhouse Strategic PBS Director, Dr Jason Crabtree.
• Clear Care Pathways: We recognise the importance of providing service users with a clear care pathway to navigate. Our structured approach ensures that individuals receive the right level of care at the right time, streamlining the care journey and enhancing overall outcomes. Our care pathway is designed to accommodate individuals in crisis or from hospital discharge to community  step up/ down home and ultimately to long-term independent living where the familiar support staff can move with the individual to provide the best opportunity to success.  
• Prioritising Early Interventions: We believe that the earlier support is provided the better the long term outcomes. There needs to be a greater focus on diagnosis and having the ability to get early support. The current diagnostic timelines for Autism assessments are dire, see the recent article https://www.bbc.co.uk/news/uk-england-67713838with some individuals been told that they need to wait up to 2 years for an assessment. Providers such as Venus, can assist via having inhouse MDT clinical psychologists who can assist in speeding up the assessment process and getting early interventions in place to ensure that individuals are not left without the support they need.  

Measures of Success: Long Term and Outcome Based

To achieve longer term outcomes, we propose a focus on the following key objectives:

• Reducing care hours: By optimising care plans and interventions, we aim to achieve a reduction in overall care hours without compromising the quality of service.
• Minimising incidents and/or police interventions: Our proactive approach to addressing challenging behaviours aims to minimise incidents and the need for police interventions, creating a safer and more stable care environment.
• Reducing hospital admissions: Through personalised care plans and early interventions, our goal is to decrease the frequency of hospital admissions, ensuring continuity of care within community settings.
• Targeted interventions: By addressing the root causes of challenges promptly, we aim to facilitate quicker progress, leading to shorter crisis placements without compromising positive outcomes.

We believe that success can be better measured by a focus on these longer term outcomes, rather than the current focus on rigid time and cost constraints. To achieve this shift, we believe that providers and commissioners need to work collaboratively to develop and implement new outcome-focused measures of success.

Our Proposed Outcome Focused Approach

“I’m willing to give people more freedom to innovate and create as long as they deliver” Wes Streeting MP

We propose that providers and commissioners agree a three to five-year plan, based on the individual’s needs, that identifies key outcomes that they want to work towards achieving. These outcomes should be SMART (specific, measurable, achievable, relevant, and time-bound).

Providers should then agree a plan of action to target these outcomes. This plan should be based on evidence and should be tailored to the specific needs of the service users.

The cost of the entire three/five year plan should be calculated on a weighted average. This will encourage both providers/commissioners to invest in interventions that will lead to long-term cost savings, such as reducing challenging behaviour and improving the quality of life of service users. Providers can then be measured on their ability to deliver on the outcomes and provide long term cost efficient care.

Conclusion

We believe that this approach will lead to a more effective and efficient social care system that is better able to meet the needs of service users.

I am the Director for Venus Singapore, I want to thank you for considering our perspective, and we look forward to the possibility of working together to achieve our shared goals for Adult Social Care.

Authored By: Sri Nadarajah