Commissioning care: is partially and manually auditing just 10% of large care packages really fit for purpose?

As experts in the care sector we know – because ICBs and care providers have told us – that just 10% of large personalised care packages delivered in non-hospital settings are audited annually. At Alocura, we don’t believe this is good enough in this era of digital working.

If anything, the conversations we’ve had understate the problem this causes for commissioners – who can’t keep a track of what is being spent on packages – and providers too. It might seem as if providers would rather not have to go through an audit process. Actually, not having the instant oversight into how money in care packages is being spent – and how a package is performing operationally – is a real problem for everyone.

This is where our end-to-end care management software Rostrata can help both commissioners and providers operate in an open book framework with full oversight of activity on a care package – but more of that later.

Back to the auditing research we recently undertook. We also found…

  • Audits take place manually with paper bank statements, receipts and invoices – often by teams of ‘auditors’ who may not have a finance background.
  • There is no facility within current audit practice to pick up misuse and/or fraudulent activity.
  • Audits are only focused on one aspect – the financial transaction – which is possibly the least important. There is very little – or no – oversight of the actual care delivered.

If you’re a commissioner reading this, perhaps naturally, you don’t always want to talk about fraudulent activity or budget misuse in the care packages you fund, but that’s not to say it doesn’t exist. In fact current practice can enable…

  • Care to be invoiced but not delivered.
  • Care to be delivered at lower competency but invoiced at higher competency charge rates.
  • Partial care to be delivered but fully invoiced – could be incorrect timesheet, GPS location or invoicing issue.
  • Care to be delivered which is not agreed in Care Plan – and not approved.
  • Care to be underdelivered and not invoiced, but funds retained.

Of course, that’s not to say this is how most care providers are behaving with commissioners. We know how difficult any care package is to manage financially and operationally, and these are issues we regularly come across. And it’s why we developed Rostrata, our end-to-end software product which provides a forensic, at the desktop and immediate level of information relating to actual care delivered and all associated financial transactions.

It’s because of this forensic level of information we can openly say there is zero misuse and fraud on the packages managed through Rostrata. The care outlined in the care plan is the care delivered.

If there is an under delivery, for whatever reason, then that money can be returned to the commissioner. In fact, in 2022/23 Alocura returned between 6-10% of every budget managed through Rostrata – money which the commissioner told us they had ‘no idea’ about.

It costs health services a small fraction of current audit costs to manage 100% of their packages through Rostrata. And while absolute oversight is a key benefit of Rostrata, there’s so much more. The ability to work in an Open Book manner with providers and support DSCRs means there are significant benefits for care providers too… Rostrata works for everybody.

Food for thought? Ask for a free trial and talk to us about piloting Rostrata with one of your approved care providers; we guarantee to find you immediate savings and efficiencies.