Explain Systems That Calculate and Justify Charges for Domiciliary Care in the United Kingdom?

Explain systems that calculate and justify charges for domiciliary care in the United Kingdom?


Domiciliary fees are considered from two directions namely bottom up associated with the cost of wages and salaries and the cost of running of the business and secondly what the market will accept as an acceptable fee i.e. competition.

The fees are paid by public funds namely social services, direct pay and community health care (NHS) and by private service users. Fees charged to public funds are at a lower level that those charged to private service users. Public funds have the benefit of negotiating a specific contract with the firm as a preferred supplier of domiciliary services which allows a bulk discount due to the volume of business that is introduced, greater information related to the condition of the service user which enables quicker assessment of care plans and risk assessments related to the public service user. In addition the public fund pays weekly which assists in the management of the cash flow of the business and the public fund is also considered a better credit risk that private services users resulting in greatly reduced bad debt provision for non-payment. However there is a shift by public funds towards “personal budgets” which are where the public fund pays the public service user directly and then the public servicer user arranges and contracts directly with domiciliary service providers i.e. giving more choice to the service user. For the public fund this should mean reduced administration as they only have to transact with the public service user. It could also mean a reduced work force by the public body as there will be less interaction, monitoring and the provision of services (particularly in support of care plans and risk assessments) resulting in a reduction in the public administration budget. However for the domiciliary service provide the service user becomes more like a private service user with associated additional work in...