The Independent Health and Care Providers (IHCP) has revealed new internal measures by the Southern Health and Social Care Trust which it says “rations home care by stopwatch, not by need”.
Internal documentation reviewed by IHCP confirms the Trust is moving to fundamentally reshape how home care is delivered, with sweeping reductions to visit length and frequency for vulnerable people.
Standard morning and evening calls are being reduced to 20 minutes, while lunch and tea calls are being cut to 15 minutes.
In parallel, many service users who would previously have received four visits per day will now see that reduced to three, alongside tighter restrictions on what tasks carers are permitted to carry out.
Crucially, these changes are being introduced without any meaningful engagement or consultation with independent providers or families in receipt of care. IHCP says this is not simply a policy shift, but a continuation of a deeply troubling approach to system management to save money at the expense of those receiving home care or awaiting a care package to enable discharge from hospital.
Particular concern has been raised about how the changes are being framed. Guidance accompanying the new model directs staff to describe care as “tailored to need” rather than time-based, while discouraging transparency around visit durations and reductions. Service users are to be reassured that decisions are not about saving money, yet at the same time are told they cannot choose their provider, visit times, or the structure of their care.
IHCP, which is a non-profit organisation representing private, voluntary, charitable and church affiliated care providers, says this represents a significant shift in how care is both delivered and communicated, raising serious concerns about transparency and trust.
This latest revelation follows IHCP’s recent exposure of serious inefficiencies within the Trust’s own internal provision. Details revealed by Freedom of Information requests highlighted a system where the Trust’s in-house home care services cost nearly double those delivered by the independent sector. It was further revealed that an average of 113 care staff are absent each day due to sickness and more than 550 care calls were missed in a single year.
Against that backdrop, IHCP argues that imposing reductions on externally delivered care packages, rather than addressing internal inefficiencies, raises fundamental questions about priorities and accountability.
According to IHCP, this is not an isolated issue but part of a clear and consistent pattern: a failure to consult with providers, the systematic reduction of care packages, sustained financial pressure on a sector already operating on the margins, and an ongoing reluctance to confront inefficiencies within publicly delivered services.
The implications for patients and families are, in IHCP’s view, both immediate and serious. Reduced visit times and fewer daily calls will mean less support for vulnerable individuals living at home, increased pressure on unpaid carers, and a heightened risk of deterioration that could lead to avoidable hospital admissions. At a system level, this risks compounding the very pressures — delayed discharges and overcrowded hospitals — that home care is intended to alleviate.
Pauline Shepherd, CEO of IHCP, said:
“This rations home care by stopwatch, not by need. You cannot deliver dignified care when time is continually reduced, and visits are removed.
“Shorter visits and fewer calls do not lessen need, they simply cut the support available to meet it.
“At a time when the Trust’s own services continue to operate at significantly higher cost and with well-documented operational challenges, the decision to reduce frontline care provision without consultation is both unjustifiable and unsustainable.
“Reducing 30-minute calls to 20 minutes, cutting lunch and tea visits to 15 minutes, and removing essential visits altogether does not constitute reform. It is rationing and presenting it as needs-led care while discouraging transparency risks undermining trust right across the system.”
IHCP is calling for the immediate suspension of the new guidelines, full transparency on how these decisions have been reached, and independent scrutiny of both the Trust’s internal cost base and its commissioning approach.
It is also urging urgent and meaningful engagement with the independent sector to ensure that any future reforms are grounded in operational reality and the needs of those who rely on care.