Significant pressures are impacting the home care sector, and providers are reportedly struggling with low workforce utilisation.
A three-year programme to trial the use of AI-based optimisation technology in home care has identified several opportunities for local authorities and care providers to improve the planning of home care, offering potentially significant benefits for care workers, service users and the social care sector as a whole.
Bristol City Council and Cornwall Council took part in a trial which sought to evaluate the impact of using Procomp’s Strategic Optimisation service, which provided data to support changes to how homecare was planned and delivered based on Procomp’s data modelling.
Specific benefits were identified in using optimisation software. These included improvements in the working conditions and retention of care workers and increases in provider revenue and efficiencies.
Care workers demonstrated increased satisfaction with their workload and the time available between home visits, as well as an increase in overall job satisfaction.
Christian Brailsford, Regional Lead for Nursing, Midwifery and Social Care with NHS England South West, said: “Integrated care plays a pivotal role in delivering high-quality services to the population of the South West. I’m genuinely enthusiastic about witnessing how AI technology can begin to positively influence the provision of domiciliary care, enhancing efficiency and enriching the experience for both care-providers and recipients within our communities.”
The challenge
State-funded domiciliary care (or home care) is provided at a local level by local authorities, generally via the commissioning of a range of contracts to multiple providers. Significant pressures are impacting care workers, service users and local authorities, and providers are reportedly struggling with capacity and sub-optimal workforce utilisation. Staff turnover in care is high with low morale and job satisfaction a common concern.
According to the King’s Fund, 818,000 people were using homecare in England in 2020/21, including some of the most vulnerable people in society, while the Care Quality Commission (CQC) has reported a further half a million people are on the waiting list, many with critical needs.
In the first three months of 2022, 2.2 million hours of homecare could not be delivered because of insufficient workforce capacity, leading to unmet and under-met needs.
Our approach
Exploring how technology could help tackle some of these challenges, the Domiciliary Care Workforce Programme was led and co-funded by Health Innovation West of England, Health Innovation South West, and NHS England Workforce, Training and Education South West.
We launched a nationwide call in 2021 to identify potential innovations. A panel of representatives from across the health and social care system assessed more than 30 applications, selecting Procomp’s Strategic Optimisation service as the appropriate solution to trial.
Procomp is a Finnish company with a background in logistics planning and optimisation. The company works with a third of the Finnish domiciliary care workforce. They use an AI-based solution to optimise planning, reduce mileage and improve carer utilisation, as well as to support key decision-makers identify and implement systemic changes.
Bristol City Council and Cornwall Councils successfully applied to take part in the trial, as part of a call to all local authorities in the South West.
Based on data modelling provided by Procomp’s Strategic Optimisation service, two rounds of changes to how homecare was planned and delivered were introduced in each locality between September 2022 and September 2023.
These changes included:
- reviewing care assessment practices
- introducing flexible start times
- balancing demand by organising non-critical activity at off-peak times
- discussions around care worker gender.
Mark Russell-Smith, Director of International Operations at Procomp, said: “We’re very proud to have been selected as the innovator in the Domiciliary Care Workforce Programme.
“An important aspect of the programme is that it’s enabled a more system-wide approach by both councils and providers. Positive improvements have already been achieved, and there is massive scope for further improvement. Not all problems will be solved overnight, and there isn’t one single solution, but these are important steps. They show how Strategic Optimisation can play a pivotal role in guiding and shaping the future of care, allowing new discussions and genuine solutions to be found to the problems facing the domiciliary care sector.”
Impacts to date
We commissioned Unity Insights to independently evaluate the Domiciliary Care Workforce Programme.
Unity Insights’ evaluation evidenced specific benefits in using optimisation software to improve the working conditions, job satisfaction and retention of care workers and to increase provider revenue and capacity.
Care workers who experienced the changes in working practices were surveyed. Their feedback was positive and demonstrated increased satisfaction with their workload and the time available between home visits, as well as an increase in overall job satisfaction.
The evaluation also evidenced a reduction in miles travelled by care workers during the first month after implementation, and several staff reported less need to cut appointments short due to reduced travel requirements.
Unity Insights’ cost-benefit analysis modelled the benefit of efficiency gains to homecare providers during the pilot. Results estimate the net present value and benefit-cost ratio between 2023/24 and 2027/28. The benefits were based on a reduction in travel distances, an increase in care packages delivered, and an improvement in staff retention. This demonstrated that the two pilot providers involved in the programme could potentially save a combined £3.58 for every £1 invested in the solution.
Procomp’s modelling of data from both local authorities, indicated potentially wider opportunities to improve care worker utilisation by 35%; reduce mileage by 65%, along with associated travel costs for providers and care workers; and improve the overall experience of service users.
Read the full evaluation findings here.
Councillor Andy Virr, Portfolio Holder for Adults Social Care and Health, Cornwall Council, said: “Procomp’s strategic optimisation service delivered a depth of insight and evidence that exceeded our expectations, empowering us to make evidence-based decisions that incentivised transformation at a strategic level.
“If successful, this new approach will enable us to improve the day-to-day experience of people who use our homecare services and their care workers. It will also enable us to enhance the pay received by our local care workforce, increase the profitability of our homecare providers and ultimately help to secure the financial sustainability of our local care market.”
Start and end dates
March 2021 to May 2024.
Next steps
The findings from the Domiciliary Care Workforce Programme present a strong argument for both commissioners and providers to explore the opportunities offered by the use of optimisation software in planning home care, as well as identifying and implementing much-needed systemic changes.
To support this, Health Innovation West of England is sharing these findings with key stakeholders, including policy makers and influencers, to explore how we best take advantage of these opportunities and overcome the identified barriers to change.
Find out more
To find out more about the Domiciliary Care Workforce Programme, email healthinnowest.innovation@nhs.net.
To find out more about Procomp, visit procompglobal.com.