Helping residents pay for care
Improving the financial assessment experience in Kent
In 2019, roughly 14,000 financial assessments were conducted by Kent County Council (KCC), including 8,400 over the phone. Staff time is spent organising appointments and conducting assessments, and there is currently no way for clients to get an estimate, upload information or complete a financial assessment themselves online.
FutureGov ran a three month discovery into KCC’s financial assessments experience within Adult Social Care to identify areas for improvement. Together, we wanted to explore ways to digitise their processes to reduce the number of query calls, which would enhance resident experiences and save staff hours of time.
Throughout the project, we mapped the as-is journey, identified and prioritised opportunities, prototyped ideas, tested and created a roadmap for development for the financial assessment process. Towards the end of the project, we also conducted a technology-based discovery to understand the constraints of KCC’s existing tech systems, which helped shape our recommended implementation steps.
The three-month discovery included 12 in-depth interviews with residents, 11 interviews and five workshops with senior and junior members from different subteams of both CFS and Adult Social Care (ASC). We also ran two meetings with KCC’s tech solution providers and sense-making and synthesis sessions.
Care needs assessments normally take place before a financial assessment. At the time residents have conversations with ASC care needs assessors, their care needs are established but they have yet to find out from the financial assessor how much they have to pay. Our research with residents told us that having to commit to care without knowing how much it would cost often causes frustration.
Our research with ASC participants revealed that even though there are existing resources, e.g. training materials, to support ASC staff to have conversations around finances with residents, they’re hard to digest and therefore underutilised.
Insights from our research also revealed that the content and layout of invoices are not led by user needs (but rather assumed technology limitations). Some residents find these invoices hard to understand, as they fail to explain what they’re being charged for and KCC’s contribution.
The current service is ultimately fragmented due to structured workflows. There's an opportunity to better support practitioners to have conversations with residents upfront around their finances and improve ways of working to increase collaboration and communication between teams.
To address these concerns we produced prototypes that the team can take forward and implement focusing on practitioner guidance and an improved invoice.
Prototype 1: Practitioner guidance
The practitioner guidance aims to support practitioners to have better conversations with residents around finances as they conduct care needs assessments.
We included a conversation and digital guide, both explain essential paying for care information such as financial support eligibility, logic and the processes of the financial assessment. The digital guide also contains links to existing resources and can become a FAQ webpage that enables residents to serve themselves.
Prototype 2: Improved invoice
The improved invoice focused on improving the common challenges described by residents during discovery. This includes an accessible font size, important information highlighted, cost descriptors rewritten using simple terms and the logic of payment as well as KCC’s contribution which is clearly explained.
We have also suggested KCC give residents the option to receive invoices by email, which we also produced.
Having illustrated how parts of the whole service can be improved, we’re eager to help create a more integrated total solution. We’ve outlined the four components of a person-centred care service:
- help residents understand the care need
- help residents understand how to pay for care
- help residents manage paying for care
- help residents find the right place/care provider
We’ve suggested programmes and tools to realise each component. ‘Digital communications’ and ‘integrated ways of working’ are the two overarching themes to make sure teams work in a joined-up way, and residents feel empowered. This will provide residents with options of different communication methods such as the option to self-service (care and financial assessment, as well as reporting change) and timely support to avoid getting into debt.
Based on our estimation that 20% of clients and their financial agents will choose to receive digital correspondence*, introducing an improved invoice alone means that KCC could potentially print and post 32,800 less documents every year, saving £20,996 in printing and postage.
The same group of more tech-savvy residents also will have the capability to self-serve when more paying for care information becomes available online in a more friendly format. We expect the number of phone assessments will be reduced from 700 per month to 560. At 30 mins per call, this could mean a total of 128 hours per month of staff time saved.**
The improved invoice is expected to also reduce the number of queries by 30-50%, which could mean a saving of 66-108 hours of staff time every four weeks.
*This is a conservative estimate calculated based on approx, 70% of clients using financial agents. We assumed a third of these would be comfortable receiving digital correspondence.
**Further work to understand system integration and design and test the self-assessment experience is required to realise this saving.