Unproductive


The Guardian reports that there has been a dip in public sector productivity in 2008. The worst offenders are those in Adult Social Care. Oops. It makes interesting reading though when you consider what is classed as ‘productivity’.

The productivity measure used by the ONS sets outputs of public services, such as NHS operations and GCSE grades, against inputs of labour, materials and capital assets.

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I expect these are those wonderful performance indicator types that we are measured on. With operations and exam grades positive results might be better determinable but if you think about social care, let’s think what kinds of things might count as productivity?

It can’t be hours of care provided as we are consistently encouraged to cut down care and tighten criteria.

Anyway, hours provided is not a factor in itself of success or failure. Even hours provided against hours provided to the same person last year as if there has been an increase it could be wholly unrelated to the effective of any service provided (through there being a deterioration in health, for example) and if there has been an increase – well, increased cost is hardly likely to be seen as an indicator of good performance.

We are marked on the  number of carers’ assessments but to be honest, carers’ assessments are mandatory anyway, so we should be doing them for everyone who has an informal carer, so working on the basis that everyone is availed of their mandatory right to receive an assessment, there is no way to ‘increase’ these. You have one, if you are a carer, or, if you don’t have a carer, no-one has one. I can’t see how these can be increased apart from by stretching the definition of ‘informal’ carer or as a previous manager once told us, to carry out carers assessments ‘on paper’ even if the carers’ themselves had refused them in order to meet the numbers (we didn’t do this and I’m not sure if she was being entirely serious when she suggested it!).

Another criteria we are measured on is Safeguarding Alerts and Investigations. Again, this is a mandatory social work function. If there is a concern, an alert/investigation is completed. You can’t really massage the figures in any way because you HAVE to do the work – the only way productivity could increase is for there to be more abuse recognised and alerted…  Maybe the lack of safeguarding alerts could be a seen as a good thing and a sign of high levels of care rather than a bad thing and an unproductive office – this is bearing in mind that a lot of safeguarding issues arise from care given in a formal capacity – residential care homes and paid carers.

We factor in timeliness in completing assessments and responding to referrals. This is all well and good and better than people waiting for months. But if the quality of service better as a direct result or is moving a limited staff team from otherwise important work to take a low level referral an effective use of time.

I would question how many of the people in the ONS (Office of National Statistics) have ever had a hands-on role working in adult social care to be able to understand the way that quality and quantity of work can be judged.

It’s a great headline though – look at those inefficient workers in adult social care – they aren’t as good as other sectors in maintaining ‘productivity’. I would say that outcome measures are currently not making any allowance for quality of care and the shame is that it is on the basis of reports such as this that jobs will be lost and services cut – and more staff time will be spent on administrative tasks which ensure that ‘outcome measures’ are favourably determined as opposed to devoting time (and money) to fighting for a high quality of care and service delivery.