As one of just a handful of Local Trading Authority Companies handling a major community equipment service, Essex Cares Ltd is relatively unique in the assistive technology space.
Operations director Joe Coogan outlines how a combination of dynamism, flexibility and a public sector ethos makes for a market leading model that even the largest nationwide contractors would envy.
What does Essex Equipment Services’ (EES) latest accreditation from CECOPS mean to the team?
We feel like we are in a good place now that the service has been recognised as a market leader. More than that, it is important what external people think about you and with CECOPS being an independent body it is really valuable to have its opinion on how we are doing.
We flew through the assessment with top marks and we were really pleased with that. It is a real badge of honour for the service and has really helped moral within the team. It is a real team effort and it is nice that they have been recognised for performing so highly and for achieving the audit without any recommendations from CECOPS. It is one of the first times that CECOPS has issued a report without any specific recommendations.
CECOPS’ assessors picked up on ‘good teamwork’ and a ‘can-do attitude’ within EES. What role does that play in the service’s success?
We pride ourselves on our flexibility as a team. We have a fantastic team manager in Trudi Foster, who is head of equipment services and has been here about three years. She is really strong in terms of her people skills and helping each member of the team in their role and how they contribute to the service. One good example is how we cope with up to about 20 same-day orders a day on top of all the jobs we already have lined up. We often get same-day requests for palliative care cases where the customer wants to go home as quickly as possible to spend the time they have left with their family.
We do everything we possibly can to make sure we deliver on the same day. One example recently was where we were asked to provide, at short notice, mobility equipment to a hospice, where the customer was getting married and needed equipment to be able to walk down the aisle. It was really nice to be able to meet that need because it was obviously really important to the person. It is good that we can offer a flexible service to be able to do those kinds of things but still hit all our KPIs.
What processes and procedures have you put in place to achieve the kind of marks you received during the CECOPS audit?
It is things like our warehouse management systems, which are now strong, and the skills and training of the staff. We teach them above and beyond. It is also our focus on refurbishments and recycling. Currently, 92% of what we deliver we collect and recycle to be used for another customer. It is fantastic for the green agenda but we also saved £1 million more for our commissioners than the year before because we increased the rates of recycling.
We can use kit more and more and the spend on new equipment fell. We recycled about £6 million worth of items last year. We try and provide expert advice to commissioners to look at not just the price of equipment but also how many times it can be reused so you can see the true cost per person. That has helped increase recycling rates and we have got better at holding a wider range of spare parts and training our staff to a higher level so that everything that can be recycled is. If two items come back and cannot be recycled we cannibalise them to create one item. You can take the best pieces of each item to create a new one.
What else sets you apart from the market’s major assistive technology service providers, which serve contracts on a nationwide basis?
We only have one shareholder and that is Essex County Council. We are not just geared towards making profits and any profit that we do make can be ploughed back into the service. I think that is fairly unique these days, most equipment providers are private companies and are often bought by private equity firms these days. What helps is that we can work with lower overheads and lower profit margins and when we do make a surplus we can plough it straight back into the service.
What are the advantages of being a Local Authority Trading Company compared to a wholly private firm?
I think there are lots of advantages. We are technically a private company so we can move quickly and be quite dynamic, just the same as other private companies. But we have got the ethos of the public sector or a charity essentially. For me, there are many more advantages to our model. It is a combination of speed and dynamism and taking a systems and people-centred approach. I have been with the company three years, I have worked in the voluntary sector, the private sector and the public sector, and ESS for me is a really good blend of all those things.
To what extent do you feel that a local company serving just one contract is able to match up to the kind of services provided by nationwide companies with all their financial firepower?
We are a fairly large company and employ about 1,300 people, so we do have a good scale. We only have one main equipment contract but if another comes up nearby that we feel is viable then we would be interested in that. There are several large providers around the country but I think the Essex contract is the biggest country contract there is. So although we have only got one contract, outside of London, we have got the single biggest contract.
Do you feel that the LATC model could work well across other areas of the UK?
Yes. The model is good but like anything it comes down to the execution and quality of the team delivering it. There are lots of great private companies and lots of great voluntary sector organisations and there are a few bad ones too. I think when you have got low margins and you are dealing with vulnerable customers the local authority trading ethos and platform works quite well.
Some industry observers argue that smaller, more local organisations do not have the logistical muscle to run an effective equipment contract. Where do you stand?
You do need a certain size and economy of scale to be able to do these things and because we only have one main contract it gets a lot of attention from our team and chief executive. We see ourselves as running one really well. The overall spend in Essex is around £15m, so it is a decent size to give that economy of scale to be able to buy equipment at a reasonable price and benefit from that volume.
I agree in that if you were a tiny district council and running a service where the turnover was much smaller, that would be difficult. There are pros and cons to scale – if you’ve got 40 contracts then then each one is going to get less time from the chief executive and the operations director. I have seen big providers run contracts really well and others that have not worked at all and everything in between.
What are the challenges associated with distributing 130,000 items of equipment out to the community?
The challenges we have are that the demand can change quite significantly from day-to-day and week-to-week. For unforeseen reasons demand can shoot up by 20% or 30% between one week and the next, depending on things like the weather or how much pressure hospitals are under. We have very strict KPIs stating that we have to deliver kit within a certain timescale so we have to have a flexible service.
If every week was the same it would be easier but when some weeks have 20% more demand we have to have a very flexible system and workforce to be able to match our resources to that demand. That is probably our biggest challenge. Also, Essex is a busy county on the roads and it is a challenge to carry out deliveries when a road like the A12 closes because of an accident.
Council budgets are shrinking. How do you find the right balance of offering a quality service and one that can operate within tight budgets?
I am very much a believer that equipment is a spend-to-save area. I think it is a good investment. If a piece of equipment can keep someone out of residential care then that can save the public service a lot of money, and the individual for that matter. A lot of our work is around hospital discharge and if we can have kit ready when it is required and it allows someone to leave hospital a day earlier, that can save the NHS £400 to £500 for one bed.
It is definitely an area where if you get your equipment service right and your spend is right, you should reduce your delayed discharges, you should reduce your spend on domiciliary and residential care and it should help people to remain independent for longer, which is crucial to balancing finite budgets in difficult times.
It sounds as though a lot can be learnt from the ESS model.
We think it is a really valued service now and it is really important for the intermediate care pathway. The key for me is the flexibility that turns a good service into a great service. Doing 20 same-day discharges and providing equipment to hospices for instance are not in our KPIs, but we think that is where we add the real value. It is the best equipment system that I have ever seen. I have worked in the North West, Merseyside and North East London and this is the most comprehensive service that I have worked with as a commissioner or a provider. It feels pretty good to be part of that.