Case Study

Continuing Healthcare Saving in North-West London


The CHS Healthcare service provided for a north-west London clinical commissioning group (CCG) has produced a saving of £101,591 in just six months.

This saving has been achieved by the domiciliary care update and invoice scrutiny service, which we provide together with the Caretrack database.

Each week, the CHS team call providers to check what domiciliary care has been actually delivered and this is entered on Caretrack. Payments are only made if invoices match this exact record of provided care.

“There is commonly a mismatch in domiciliary care which is very expensive for the NHS,” explains Harry Bourton, Caretrack Operations Manager.

“Invoices for domiciliary care are usually paid by finance departments removed from the day-to-day delivery of that care. Providers simply submit invoices for the level of care originally commissioned and this does not reflect the fact that very often, fewer hours are actually delivered.”

Reasons for this are usually: client has family visiting and does not need or want a visit at a particular time, or is out of the house for a medical appointment. Although the amount of hours not provided is fairly low per individual, because of the large number of clients and hours involved, accurately identifying hours not provided delivers huge savings.

In the north-west London CCG, the saving produced by in the first six months (September 2015 to March 2016) by CHS Healthcare equates to 6.1 per cent of the commissioned domiciliary services for clients who have continuing healthcare funding.

“We are always confident that we can produce a saving of at least five per cent of overall budget in the first six months of the service,” says Mr Bourton. “We are very pleased that in this service for a north-west London CCG, we have significantly exceeded this target.”

Taking into consideration the cost of commissioning CHS to provide this service, the net saving in the period is £76,091.

Domiciliary care updates and invoice scrutiny is a longstanding service, with established systems for achieving savings and accuracy. In Eastbourne, where we have been working since 2010, a saving of £250,000 was achieved in the first year. Domiciliary care update and invoice scrutiny is also provided in Brighton, Wiltshire, Ealing and Wandsworth.

As well as achieving very significant net savings, this service provides valuable quality assurance. Every month, the CHS team call each client’s next of kin to check on the quality of care provided. “This is something we do without fail as part of the service, with evaluation recorded, thus providing a very important quality assurance measure for CCGs,” comments Mr Bourton.

*Although we are not including the name of the CCG at their request, we are very happy to provide further information including data and references from the CCG to validate and expand upon these savings.