An empty house at lunchtime
A client was taken to hospital by ambulance at 11pm. The evening carer knew, and texted the on-call coordinator. On-call made a note. In the morning, the coordinator was dealing with two sick carers and did not see the note until mid-morning. The breakfast carer had already arrived at a locked house and waited, then rung the office. The lunchtime carer did the same.
At the end of the month, the invoice to the council included three days of calls that did not happen. The council queried it. Meanwhile, the hospital rang on a Friday afternoon to say the client was being discharged that evening, and the agency had given the calls away.
Why calls keep running
Cancelling a client's calls is not one action. It means changing every future call in the rota, telling each carer affected, stopping the invoice, and recording the admission. Each step may be done by a different person, and on a busy morning some are forgotten.
Information about admissions arrives in odd ways: from the carer who was there, from a family member, from the hospital, or not at all. It often arrives out of hours.
The restart is the other half. Discharge dates move, often at short notice. Agencies want to keep the client's times available, but cannot hold them for ever when other clients need them.
Family members add another route. Sometimes a son rings to say his mother is in hospital, and the person who answers is not a coordinator. The message is passed on, or written on a pad, and the suspension depends on it reaching the right desk before the next call is due.
What an unsuspended client costs
| Missed step | Effect |
|---|---|
| Rota not changed | Carers travelling to empty homes |
| Carers not told | Wasted time and worried phone calls |
| Invoice not paused | Queries and credit notes from commissioners |
| Time not released | Other clients waiting while slots sit unused |
| Restart not planned | Discharge scramble, or calls given away |
Commissioners also notice when invoices include calls to clients who were in hospital. It does not help the relationship.
One-step suspension
- A suspend action on the client record, usable by office staff and on-call from a phone, with the reason and the date and time it starts.
- Future calls marked as suspended in your rostering system through its API, or listed for the coordinator where the system cannot be updated directly.
- A message to every carer with an upcoming call for that client, telling them not to attend.
- Invoicing paused from the suspension time, with any rules you have about notice periods or retained payments applied as your contracts set out.
- Freed slots listed for the coordinator, with a choice of holding them for the client for a set time or releasing them.
- A discharge tracker with the hospital ward, contact and expected date, and reminders to check in, so the restart is planned and the carers are told when calls resume.
What you charge or are paid while a client is in hospital depends on your contracts. The system applies whatever your contracts say.
An admission handled in minutes
When on-call hears a client has been admitted, they suspend the client from their phone. Carers are told, the invoice stops and the coordinator sees the freed time in the morning. The discharge tracker keeps the restart on the radar.
When the hospital rings on Friday afternoon, the coordinator knows the client's usual carers and times and can restart calls without starting from scratch.
Recognise any of these?
- Carers arrive at homes of clients who are in hospital
- Invoices include calls that did not happen
- Admissions reported out of hours are lost until morning
- Discharges arrive at short notice and cause a scramble
- Freed time is not reused while the client is away