Independent arbiters can help councils negotiate the 'fair' cost of care

Who foots the bill for these spiralling costs - local or central government, the public, the NHS, individuals themselves - and where or to what extent caps have to be set, is likely to become one of the most important, and difficult, decisions this country will need to make in the years ahead.

People are living longer and there is, if anything, going to be even more demand on residential nursing care in the future

Already, in the current financial climate, adult care costs are a headache for many local authorities. People are living longer and there is, if anything, going to be even more demand on residential nursing care in the future. Adult care will often be one of the most sizeable drains on a local authority’s budget and yet it is also something that doesn’t lend itself easily to trimming.

Last year’s court battle in Sefton MBC over the council’s decision to freeze the fees it paid to homes for elderly residents highlights very clearly the sort of battlegrounds we may see becoming more common.

One of the issues with the current system is that, with councils and providers both using cost-of-care calculators to come up with a ‘true’ cost of care, inevitably, both end up with figures that reflect their own conflicting agendas and end goals.

But it doesn’t have to be this way. Councils and providers do not have to become locked into an increasingly legalistic, acrimonious, ‘nil uplift’ relationship that benefits no one, least of all residents and their families.

Councils and providers alike, we argue, could, in fact should, be making much better use of independent parties - independent arbiters - to help them to negotiate what is the ‘fair’ cost of care in a locality or neighbourhood, and therefore reach a more consensual agreement on fees.

In a costing negotiation where every penny counts national or even regional benchmarks are just not specific enough. Data that is current and collated locally better reflects the costs of operating in the area and thus the fair, overall cost of care.

The more important point to make is that getting care budget decisions right is so vital, both financially and in terms of societal and community expectations, that they should not be being made against a backdrop of the threat of legal action.

David R Smith, director for government and public sector, PwC

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