Grow my care business · Commissioning and pricing
Most care businesses are not underpaid. They are underpriced, and nobody has ever asked.
What an hour or a place actually costs you, what you are being paid for it, and how to put the difference to a commissioner in a form they are able to act on.
Where the gap comes from
Six ways a rate stops covering the work
None of these is dramatic. They are all quiet, and they compound, which is why a service can be fuller than ever and worse off than last year.
Price
A rate set years ago and rolled forward
An uplift applied to a number that was already wrong is still wrong, and it gets further from the truth every April. Very few providers can say how the original figure was built.
Cost
The hourly cost is not the hourly wage
Employer's National Insurance, pension, holiday pay, sickness, training, travel time, supervision and the time between calls. The gap between the two numbers is routinely a third.
Cover
Paying twice for the same shift
Agency covering a vacancy you are also paying to recruit for, overtime absorbing what the rota should have absorbed, and a training bill that buys people who then leave.
Utilisation
The empty bed and the unfilled hour
Fixed costs do not move when occupancy does. A service priced at ninety-five per cent occupancy and running at eighty-two is losing money on purpose without meaning to.
Contract
Terms nobody read after year one
Indexation that has never been triggered, review clauses nobody has invoked, and additional needs being delivered for free because the variation was never raised.
Funding
Money you are entitled to and have not asked for
Continuing healthcare contributions, funded nursing care, additional needs payments and one-off grants. None of these arrive unrequested.
What a commissioner can actually act on
Commissioners are not refusing you out of unkindness. Most of them cannot pay a rate they cannot evidence to their own finance team, and most uplift requests give them nothing to evidence it with.
An open-book cost per hour or per place. Built from your actual payroll and your actual overheads, not from a sector average, and shown as a calculation they can follow line by line.
The specific change since the rate was set. National Living Wage, employer's National Insurance, insurance, food, energy, and the dependency of the people you are actually supporting now.
What the alternative costs them. A handback, a placement move, an out-of-area placement or a hospital bed. This is the number that moves a decision, and it is almost never in the letter.
A specific ask, with a date. "We need a review" is not an ask. A figure, an effective date and what you will do at each answer is.
Start with your own numbers
The margin and break-even calculator works by the hour or by the place. It shows where every pound goes, what your margin really is, and the point at which you stop making money. It stores nothing.
Work out your marginWhat we actually do
Four pieces, usually in this order
The first one is often enough on its own. Plenty of providers find the money in their own figures and never need the rest.
01
Read the real numbers
Payroll, rota, occupancy and overheads against income, by service and by contract. Costed properly rather than averaged, so you can see which parts of the business subsidise the rest.
02
Build the rate
A defensible cost per hour or per place, an open-book model behind it, and a price you can hold in a negotiation because you can show how it was arrived at.
03
Put the case and negotiate it
The letter, the model, the meeting and the follow-up. We will sit in the meeting with you if that helps, and we will tell you honestly when an ask is not winnable this year.
04
Take out the cost you should not be paying
Agency dependency, insurance, rota design and procurement. Cost reduction and price increase are the same project from opposite ends.
If tendering is the real question — framework applications, dynamic purchasing systems, spot versus block, and whether a contract is worth bidding for at the price it is offered at — that is the same conversation and we do it on the same call. Bring the invitation to tender.
What we are not
We are not accountants and we are not insolvency practitioners. We work alongside yours rather than instead of them, and where the answer is that the service cannot be made to work at any achievable rate, we will say that plainly rather than sell you a project.
That answer is uncommon, but it is not rare.
When this is worth doing
Before April, not after it. Uplift decisions are made on a cycle. A case that arrives after the budget is set gets a sympathetic answer and no money.
Before you take on more. Growing a service that loses money per place makes the problem larger, not smaller. Get the unit economics right and then grow.
Before you sell. Price and margin are what a buyer values. A rate review concluded before a sale is worth considerably more than the same review concluded during one.
Commissioning strategy and local authority positioning
How you are seen by the people who place. Positioning, rate negotiation, and the relationship work that decides whether you are on the list before a tender is even published.
Most providers meet their commissioners only when they want something. The ones who do best are known quantities by then.
Already have a tender in front of you?
That is a different and more urgent piece of work, and the deadline shapes what is worth doing.
Tender supportBring us your numbers. We will tell you where the money is.
Thirty minutes, no charge, no obligation. A recent payroll summary and one contract is enough to have a useful conversation — do not tidy anything up first.
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07426 919823If it is easier to write it down than say it out loud, send a message.