To market, to e-market for social care
- Summary:
- More than a quarter of English local authorities have introduced e-marketplaces to enable citizens to buy social care in a model not dissimilar to the US Health Insurance Marketplace. Will such platforms transform service delivery or simply end up replicating old models?
It may not have entered common consciousness just yet, but more than a quarter of local authorities in England have gone down the route of setting up e-marketplaces to enable citizens to buy social care.
The principle is not dissimilar to the US Health Insurance Marketplace. But rather than help people search for and enrol in a health insurance plan, the aim of many English e-marketplaces is to assist citizens in finding and signing up to both formal and informal services in line with their personal care plans. These services range from end-of-life care and carer support to repair and maintenance and leisure activities.
The market for such platforms is nonetheless an immature one, according to a report by progressive thinktank, the IPPR, entitled Next-Generation Social Care: The role of e-marketplaces in empowering social care users and transforming services. It points out:
Both providers and councils acknowledge that e-marketplaces remain in their infancy, and have a long way to go before they are either widely implemented or fulfilling their potential as mechanisms for delivering meaningful choice and personalisation.
But it is just this ability to provide users with meaningful choice and personalised services that is at the heart of the UK Care Act 2014, which kick-started the rise in interest in the e-marketplace approach anyway.
The Act states that local authorities (LAs) have a duty to “facilitate a vibrant, diverse and sustainable market of care and support provision”, whether individuals are funded by the state in the shape of managed personal budgets or are self-funding.
The underlying message here is about ensuring citizens are equipped with enough information and sufficient means to make their own service arrangements rather than fall back on the state and its increasingly tight resources in an age of austerity unless they really have to.
Philosophical shift
But this approach implies quite a radical internal philosophical shift in how such services are provided as it entails moving from a care- to a user-based commissioning focus.
Cultural transformation of this type inevitably takes time, but e-marketplaces are being created now. So as the IPPR report points out, it raises question marks over whether LAs will simply end up replicating existing models of service organisation and delivery rather than introducing radical change.
Another linked point is that “digital services must be designed around the user’s experience and journey” rather than local authorities’ business needs by involving them in the system design process – a scenario that all too often does not appear to happen.
A further consideration is that local councils need to undertake proactive “market facilitation”, not least to encourage small and medium-sized product and service providers to get involved.
But a fundamental problem at the moment is the apparent general lack of awareness that these sites even exist. Very little publicity combined with poor rankings when using basic online search terms such as ‘buy social care services’ have combined to keep their profiles low, raising questions over current user numbers – and how they will be measured.
Although not entirely representative as a lot of e-marketplaces appear to have been commissioned outside of the LA corporate web team, a quick glance at a Website Performance Service graph indicates that social care currently accounts for a mere 2.6% of all visits to UK local council sites. The graph is produced by Socitm, which represents UK local government IT managers.
But the picture is also mixed in terms of the depth and breadth of offerings available. At one end of the spectrum, some consist of little more than directories. But at the other, it is now possible to purchase a reasonable range of services and products, with some sites appearing to target families, while others seem to focus primarily on the elderly and disabled.
E-marketplace clusters
As to where the idea behind e-marketplaces came from in the first place, however, they were initially the brainchild of social inclusion charity In Control.
It first set up its own version, shop4support.com, in 2009, which was acquired by US-based management consultancy Public Consulting Group about five years later.
Shop4support currently provides services to 16 local authorities from its UK base in Wigan, 13 of which in the Yorkshire and Humber region have got together collectively to implement it.
But the organisation also has the stated aim of becoming “the default solution for those with any health or social care support needs", which means that we are likely to hear a lot more from it in future.
One organization that is planning to take it on, however, is Northamptonshire Country Council. It has set up a three-way, jointly-owned commercial consortium called breeze-e Enterprises Ltd, together with equity partners cloudBuy, an ecommerce platform supplier, and Grass Roots, which provides customer, supplier and employee engagement services programmes and whose role it is to improve site stickiness.
The initial goal of the breeze-e e-marketplace is to offer services ranging from domiciliary, day and respite care to private hire transport and complementary therapies to Northamptonshire’s addressable customer base of 700,000.
Service providers, which the consortium began actively recruiting towards the end of last year, join the platform for free and are given access to an adult social care market estimated to be worth in excess of £400 million. In return, they must agree to be checked out by trading standards officers to ensure they match public safety requirements and be subject to online evaluation reviews by users.
Stimulating the market
The council, meanwhile, expects to make about £2 million from the venture over five years starting from the financial year 2016/17 due to the 2% fee incorporated into each transaction a la Amazon or e-Bay
The aim is to undertake a “big bang” promotional launch of breeze-e by early autumn this year for the citizens of Northamptonshire, but to start expanding beyond the country’s geographical borders very quickly after that – to which end, the organisation is already in “pre-contractual negotiations with others”, says Paul Blantern, the Council’s chief executive. He continues:
The dream is that, in the same way people go to Amazon to buy books and DVDs, they’ll come to breeze-e for anything to do with adult social care and support services.
In fact, he believes that his e-marketplace has the edge over rivals not only because its functionality is “much deeper and broader”, but because it looks slick and commercial, the objective being to make it attractive enough to become the “go-to destination” for self-funders as well as the more captive audience of managed personal budget holders. Moreover, Blantern adds:
To try and improve stickiness, if you log onto breeze-e with your account, it knows where you are geographically and will say ‘there’s an optician here and if you buy through breeze-e, you’ll get a 10% discount when you buy new specs’.
So whether you’re self-funding or funded by the state, your budget will sit there in a similar way to a Paypal account and no one will know what the source of the money is – which is quite important in terms of how we aimed the site.
Key priorities as the consortium undertakes beta testing over the months ahead are ensuring that transaction flows work smoothly for both users and service providers and that site stickiness is up-to-scratch in order to ensure both groups want to go, and stay, there. As Blantern concludes:
The more it becomes the place to go, the more providers will go there and so there’ll be more choice, which should drive down prices. Our hope is that it will be a tool to stimulate the market.
My take
Although it is still very much early days for social care e-marketplaces, given the strictures of the Care Act and the UK Government’s ‘Digital by Default’ agenda, it seems likely that adoption will only increase – and quickly – as a means of complying while keeping costs down.
It remains to be seen, however, whether local authorities will continue to reinvent wheels in a fast-changing technological world or whether they will opt to cluster around providers already offering them commercial platforms to exploit.
It will also be interesting to see into the longer-term what impact going digital has in terms of empowering citizens and whether it will lead to a proliferation of more tailored products and services at a better price – or simply end up replicating traditional care provision models as old assumptions are baked into the design process.