JOIN OUR RALLY: Sat 3rd SEPT, 12.30-2pm Meet at Greenway Centre, Southmead, BS10 5PY

Thursday, 1 September 2011

WHAT A RIP OFF! Private sector Homecare agencies overcharge by at least £5million and the Council does nothing for five years

Bristol City Council agreed five years ago to introduce a Electronic Monitoring system to prevent known overcharging by private homecare companies: at a cost of £931,506 each year (at 2006 prices).  This system has STILL not been introduced.  This has cost the City over £5 million in payment of excess bills.  Either the political leadership of Bristol City Council is unable to exert control over the performance of management, or the leadership itself is turning a blind eye to these overpayments.  This is in clear contravention of the Councils own anti-fraud and financial management policies.[1]  At a time when critical cost comparisons are being made between the Council’s own Homecare service and the private sector, Bristol City Council is unable to know precisely how much homecare is actually delivered when it pays for private sector provision.  By default, charging for time where care is not provided gives the private sector a considerable competitive advantage and makes their costs look lower than they actually are.’ 

The overcharging of £931,506 per year was first identified in 2006; [2] the Authority decided to invest in an Electronic Monitoring system (EMS) for all Homecare services in the City.  £500,000 was set aside for the purchase and operation of the system over an initial 5 year period.[3]  Now, five years later, Unite is aware that throughout the entire period, EMS has not been implemented. 

In the Evening Post today, the Council has tried to defend itself by claiming there has been a delay of a FEW MONTHS!! (see  Err, 5 years is 60 months, not a few and we're still counting!  They claim: "phase one has been completed and the second phase is a couple of months behind schedule."  Exactly what 'phase one' and 'the second phase' are remains unclear - perhaps they are strange movements of the moon?  More important is the Council's confirmation that "Providers have been told that they have been overpaid and this money will be recovered by the end of this financial year".  The savings anticipated are actually more than £1million a year.  So the private sector has been overcharging, to the Council's knowledge, for 5 years.  They have worked out that at today's prices there has been an annual rip-off to the tune of over £1 million.  But the best bit from the council is this little gem: Recovering the money from the private homecare companies "will need careful planning to AVOID CAUSING UNSUSTAINABLE CASH FLOW PROBLEMS for some providers".  That's right, the Council can't ask for the money back because the private companies could go bust.

If fact, that's the reason why the EMS was not introduced earlier.  The Council keeps claiming their own service is too expensive when compared to private sector costs . . . even though keeping the private sector going has depended on a system of overpayment to make private sector prices look as low as possible.

This well-orchestrated collusion between the Council and its private sector homecare outfits has involved managers coming up with a stream of excuses over the past five years which include:

December 2008:  The project was been delayed due to a number of operational reasons but would be up and running in early 2009.  This would play ‘a significant role’ in cost savings/efficiency improvements.[4]  It is minuted that Councillors are: ‘deeply concerned that the EMS had been delayed.  They had been led to believe this system would be in place 18 months ago and in the meantime potential savings were not being made.[5]  Managers assure them that they have now identified the ‘most suitable system’, acknowledge the EMS as ‘fundamental to the service achieving the savings and efficiencies required’ and are required that the matter be ‘resolved urgently’.[6]
March 2009: Managers report that an ‘EMS Project Manager’ was working on a first stage of implementation which would be ‘quick to introduce’ and deliver ‘immediate results’.[7] 
October 2009:  Delays had occurred because they needed to ‘tighten the specification’ but the tender was now going out and EMS would be implemented in financial year 2010/2011.[8]
December 2009: Director of Health and Social Care confirms that EMS will ‘enable the precise amount of home care provided to be accurately recorded; this will prevent users sometimes being overcharged’.[9] 
October 2010: Cllr Jon Rogers, Executive Member for Health and Social Care confirmed that the purchase of an EMS system for homecare was ‘on target’.[10]  Director of Health and Social Care reports that the size of home care packages purchased from the independent sector is too high.[11] 

As of August 2011, the EMS system has NOT been implemented by Bristol City Council.  For the past 5 years the Council, according to its own figures, has been overcharged by private sector homecare providers by at least £5million (we still dont know the true figure, perhaps we never will). The Council has failed to take action to remedy older people being asked to pay for care which they didn’t actually receive and the Council itself continues to financially support overcharging by private homecare agencies’.


[1] Bristol City Council’s policy of financial risk management stipulates that financial issues in any of its departments which indicate a likely loss or benefit of over £500,000 OR a fraudulent loss of over £25,000 are categorised as high risk. Appendix 1 p9
[2] Appendix: business case financial spreadsheet, project ID ACC0014.  Introduced in other Councils, EMS had reduced the incidence of private agency overcharging and the associated billing of older people for services they hadn’t actually received. (see p3).  The Department of Health Care Service Efficiency Delivery project reported cost reductions through EMS of 17% of total commissioning budgets in two studies. (see p3).   Through EMS one local authority discovered that 23% of the 15 minutes visits it commissioned from the private sector in reality lasted less than 1 minute. (see Decision Report p2 )
[3] Cabinet meeting 8th February 2006


  1. Why wait 5 years for an expensive electronic system that never appears?

    If savings of around £1m can be achieved, why not just employ a team of people to manually go through all the payments and find the dodgy ones?

    A team of three people could pay for themselves eight times over every year.

  2. It may not have been implemented for some private care companies but it has in mine. You call in when you arrive and when you leave. If you are attending a 30 minute visit and you call out before 27 minutes of that visit is up you don't get paid - simple.

    Two of my friends work for different private companies and they use the EMS also.

  3. homecaresupporter2 September 2011 at 09:46

    Hi - thanks for the point about private companies using EMS. Yes, some use it to make sure they pay staff as little as possible - but that information is not shared in a co-ordinated way with the Council. So the Council has no sure-fire way of knowing if there is a difference between what you report on your EMS to your employer and what your employer invoices them for.

  4. Every month with our wage slips we get a computerised print out of every call we make. If the service user's care is paid for through Bristol City Council, if you should happen to go over your allocated time even in cases of an emergency you won't get paid an extra penny.

    However, if the client is a 'private' client, paying from their own pocket and you go over your time then you get paid, they will be charged for the whole hour if you are there for more than 47 minutes.

  5. homecaresupporter2 September 2011 at 10:16

    That seems really unfair, it must mean you are under pressure not to give extra time to Council clients when they need it. Presumably you have to rush to get off and do the next visit?

  6. If a client needs me, whether they pay privately or are BCC, then I will stay there and give them the care they for as long as they need it. We are constantly under pressure anyway as the calls are so tightly crammed and you get around 5 minutes to travel between calls. Obviously you only get paid for the time you are with the client so you could be working for 6 hours and in reality get paid only for 4.

    I know that some Carers will not, or are very reluctant to go over their time if a client is 'funded' by the council though. But with the huge pressure to be on time for calls, a stacked rota and unfeasable travel times unfortunately this goes for all care.

  7. Homecaresupporter2 September 2011 at 10:52

    Dear Anonymous
    Have you got an email address I can contact you on (anonymously)? - I won't publish it here but I could send you something you may be interested in without having to ask you in public on this site.