Work

Changing the care system

I recently reflected on the failure of Otto (my OG startup). I said it was a 'big massive huge failure', yet I am thankful for it. The trials in the past lead us into today, and I wouldn't have it any other way. 

There's a tale of a miner who looks back over a hard life and concludes: 'there were no forks in my road'. He means we never have any alternative routes, although it may feel like we do. Maybe there is only one destination, with one path there, and any sense of sovereignty over our decisions is illusionary. Ultimately the experiences that are a hard are unavoidable and play a positive role in our lives.

Since Otto, I’ve been fortunate that the last year and a half has been (work-wise) extremely fun. It's a long list of problem-solving in a sector that's cold to innovation (for reasons we won't discuss now).

The journey of building a business is an intellectual pursuit. It forces deep thinking and patient action. It's a forcing function for discipline. So, while I've been abroad, I've typed about some of the hurdles we're climbing over. This process helps me think more about (so thanks for subbing). 

Yet this summer, when in the UK, a couple of people have asked 'what to you do'. It's a good question. In our relentless pursuit of getting niche (and stalking product/market fit), Yokeru has changed a little. 

What we do

When a carer knows, in a community of 10,000 people, who needs help, those people can get supported first. If they do, the individual will suffer for a shorter time and receive better support. There is a reduced cost, too, from fewer ambulance trips or hospital admissions. 

Councils have a responsibility to care. So, Yokeru helps councils have 10,000 conversations a minute with their service users. We do this with AI (automated) phone calls, which the council controls on a web app. These conversations identify who might need help. (They are wellbeing phone calls, or medication reminders, or in response to a pendant press, plus others).

Today, tech (in the most general sense) is not used to understand wellbeing. Nor is tech used to find unmet needs. Councils use either face-to-face visits (stopped by COVID) or human phone calls (expensive). Other mediums, like apps or email, are digitally exclusive of the most vulnerable, too. Because of these constraints, there isn't very much proactive outreach at all.

So, what we are doing is changing the care system from being reactive to proactive. Take, for example, Nelly. Nelly runs out of meds, falls, and spends some time in hospital. The council finds out on admission to hospital: She gets help reactively. In a new, proactive model, the council asks Nelly whether she has enough meds, or needs help. She receives support before she falls, avoiding admission and suffering.

And this change (which Yokeru forms a small part of) is the only way to save the care system from the immense demographic pressures it is lives beneath. 

Why this is important

This post, and the entire Yokeru project, comes at an interesting time. Last week there was an uproar about the tax hike to pay for adult social care. It's outed as a Brexit Tax. And the Conservatives have reneged on their manifesto commitment to freeze taxes.

Here's some uproar*. From Dom Cummings: 'The PM's plan to break his election promise and raise taxes is a big policy and political blunder … Unable to grip Whitehall or change anything important all [Boris] can think to do is announce more spending.', and here's Starmer: "This is an unfair plan that doesn't work. And who is left with the bill? It's working people. It's especially low earners and young people who have already borne the brunt of the economic impact of the pandemic". Neither are glowing endorsements (although expected on both counts). 

The vote went through. Yet there are still problems. From the London Playbook, here are two that stand out: 

It's not enough: After policy wonks and the care sector had time to look at the details, criticism of the policy — which was initially muted on Tuesday — is now starting to mount. Nadra Ahmed of the National Care Association is on the front page of the Guardian warning: "This is a recovery plan for the NHS and that is very obvious. The funding pot being talked about for social care is not sufficient to even address the issues of today. …"

Never-ending backlog: For the first three years the new money is focused on clearing the NHS coronavirus backlog, yet there are serious doubts that can be done on that timeline and fears more money will still be needed for the health service, potentially putting the social care funding under threat. Chris Smyth reports that new NHS chief exec Amanda Pritchard refused to sign off a commitment to treating 30 percent more patients by 2024-25. Instead, the government had to announce only a 10 percent increase by 2023-24. 

Indeed, the issue is an order of magnitude more significant than this recent tax raise can deal with. As the Guardian says (often) we need to 'fix a broken system', and 'Cuts to local authorities' funding mean increasing numbers of people in England and Wales are no longer receiving care such as help with washing, dressing and eating ... . It estimates that 1.4 million older people do not get the support they need.' Most papers repeat the same. The zeitgeist is well aware of the crisis caused by too little spending and growing vulnerability.

So this is the context we're working in: an underfunded system that is life-critical to us all. It's hard to break into because of those two facts. As I said in our opening this morning, building Yokeru is about solving problems. There are more to solve (many more!), yet it's increasingly vital that we do. After all, there will not be more money for care, or fewer vulnerable people, any time soon. With tech (like ours), we are making the system proactive and effective so that Nelly can say, "hey, yes, I need help", and get it.

So, there you have it (Granny). An overview of what Yokeru is doing and some context about why.

Have a nourishing week. 

H

*Sorry if you're like me and try and hide from the day-to-day news cycle. It's draining.