What is the difference between the Median Rate and Cost of Care rate?
The Median Rate is a calculated figure from providers that have completed the cost of care tool. The median rate is the midpoint range of a series of numbers/figures. As part of this calculation figures that are well above or well below may be discounted is they are proportionally out of range of what is known as an allowed tolerance.
How do you calculate the Cost of Care rate?
The Cost of Care rate is a validated figure as a result of reviewing the analysis of provider submissions and the median rates, previous cost of care tools, financial factors such as inflation and our commercial prospective of the market.
How do you apply the Cost of Care rate into future procurement or refreshes?
Each service or contract will use the intelligence provided by the Cost of Care exercise and financial envelope within our Adult Social Care budget. The Team will work with stakeholders to agree if any financial uplifts are required for that specific contract and will make recommendations on any strategic uplifts across a service or contract.
For an annual refresh this process is usually started in September/October each year and implemented in the following April. For any annual refreshes it is subject to the financial envelop provided by Central Government.
Is the Market Sustainability Plan the same as your Market Shaping Strategy?
The Market Sustainability Plan is document developed specifically for Central Government to provide assurance that as a local authority we have a clear understanding of our existing market and the direction of travel we plan to implement over the next 2/3 years. Our Market Sustainability Plan was actually developed at the same time as our Market Shaping Strategy. Our Market Shaping Strategy will be issued in February 2023.
The Market Sustainability Plan does also include a section on the potential impact of the Social Care Reform to the Council and our social care market. The impact has been identified and the Council will be working with our providers to understand the full impact to day-to-day market activity and shape the delivery of the Social Care Reform for October 2025.
Will ECC median rates be benchmarked against other similar geographical county areas?
Some initial analysis has been completed to compare our median rates with our Eastern Region Authorities. A wider comparison with other Geographical sized authorities has not yet been completed but we will aim to do further benchmarking as information is shared nationally.
What would the median rate have been if you had not excluded outliers?
This has not been calculated as we wanted to use a statistically valid approach. It is important to note that the exclusion of outliers was at both the top end and the bottom end. Note that the median rate will not be the rate used for calculating contractual uplifts as we don’t have one rate across Essex. The information submitted by providers is used alongside our commercial, financial and commissioning insight to inform our decision-making process and planned uplifts.
Why are your rates lower than those of neighbouring authorities?
Having reviewed the ADASS East Regional Fair Cost of Care data, our rates are comparable to our neighbouring authorities both for both residential, nursing and domiciliary care.
Why was there no engagement with providers prior to submission of your median rates?
The Council has undertaken a range of work with providers to encourage participation within the timescales specified by Government.
What was the cost for Loughton, Epping?
The median rate is a blended rate across the county.
Please can you explain why the Laing and Buisson's figure of 10% was not used.
LaingBuisson made a proposal for a 10% profit margin, however the data within the returns for our domiciliary market meant on average providers had a 5% profit margin.
For residential and nursing care, it was agreed to keep the profit margin consistent with our domiciliary market and is comparable to the rates used regionally.
Have all provider responses from Tendering, Maldon, Uttlesford, Epping Forest and Castle Point been disqualified?
We are extremely grateful for all providers that took the time and effort to complete the Fair Cost of Care Tool Kits. No one has been disqualified by virtue of which part of the county they come from. All information provided whether fully or partially validated have been used to support the outcome of the Fair Cost of Care exercise.
Why are some responses ousted, noting the time and costs providers invested in completing these exercises?
For the Fair Cost of Care exercise Department of Health and Social Care (DHSC) and the Local Government Association (LGA) advice was to ensure we dealt with outliers and any zero returns in a consistent manner. Therefore, we removed the biggest outliers at each end of the spectrum so that the median cost was neither artificially deflated by zero or close to zero values, or erroneously inflated by statistically significant outliers.
The Council appears to have confused itself between a statistically produced and justified median rate and a "Fair" rate.
The fair cost of care exercise nationally required councils to identify a single median rate for the cost of care, looking at domiciliary/homecare services for people over the age of 18 and residential and nursing care for older people over 65.
For a county the size of Essex, with different demography and a mix or rural and urban areas, a single median rate cannot reflect that diversity and will not automatically or necessarily be the rate we would use to set our contracts. As would be expected, we have excluded outlying submissions at both the very high cost and low-cost ends to avoid statistical distortions. The outcome of the exercise provides Median Rates which is submitted to Government. We have triangulated this information with other commercial/commissioning and financial lens on our domiciliary market, which informs our Cost of Care rate(s) each financial year and the decisions made on uplifts for our markets.