"Proposed Charge by NAH&SCP"

Regarding Dirrans Centre, Kilwinning

Proposed Charge/Contribution to Cost of Service.

I attend the Dirrans Centre on a weekly basis, having been referred there following my having a stroke and subsequent mini strokes.

I attend the Otago Strength and Balance Exercise Class, and have gained greatly from that, and it maintains my level of physical ability.

The staff at Dirrans Centre are very dedicated people, supporting a range of service users with varied needs arising from strokes and other brain injuries.

The staff are exceptional, and very motivational to myself and other service users.

This facility is, I understand, a jointly managed unit between NHS Ayrshire & Arran and North Ayrshire Council, reflecting the vital input to the health and wellbeing of the service users.

This purpose built Brain Injury rehabilitation Centre cannot, I believe, be designated as a Day Care centre.

Very recently I have had notice from North Ayrshire Health & Social Care Partnership regarding a proposal to charge for attendance  at Dirrans Centre classes.

The proposed change is stated as £19.79 per session.

While this is supposedly equivalent to Day Care charges, the reality is not so, in my view.

According to website information, the Day Care services are charged at £14.80 per day currently, and this charge includes transport, personal care, and meals, and covers a typical attendance duration of 3 or 4 hours for that charge.

By comparison, the classes provided at Dirrans Centre have a typical session duration of 1 to 1.5 hours, and the great majority do not include a meal provision.

Therefore, the appropriate current rate for a typical Dirrans class lasting 1.5 hours, charged at exactly the equivalent of day care rate, would be:

£14.80 / 3.5hr = £4.23 / hr x 1.5hr duration = £6.35 per class session, and would in fact be less than this if the meal element is excluded, which is appropriate to a number of activities.

The Proposed Charge of £19.79 blanket charge per session is therefore more than three times the equivalent Day Care current charge rate.

One of the stated principles is also not to charge more than the cost of providing the service.

If an average Rehabillitation Worker salary is around £25000 p.a., as per internet information, and allowing for employer costs for National Insurance and Pension Fund ( approx 15%), therefore total staff salary cost is around £28750 p.a., which equates to about £15.75 per hour on a 35 hour working week basis.

In my experience a typical class / activity has 3 or 4 participating service users, and lasts for 1.5 hours maximum.

Therefore the total staff cost per class would be :

1 staff member = £15.75 x 1 x 1.5 = £23.62 maximum, or

2 staff members = £15.75 x 2 x 1.5 = £47.25 maximum

In a typical class of 4 service users the staff cost of providing the activity, per user, per 1.5 hour session, is in the order of

£5.90 for a one staff member class, or £11.80 for a two staff member class.

Therefore, the proposed rate of almost £20 per person per session, exceeds the staff cost by a factor of 3,4 times (1 staff) or 1.7 times (2 staff).

This clearly contravenes the stated principle of not charging more than the cost of providing the service.

The people attending the activities do so due to health issues, and I believe some will be financially excluded and prohibited from attending due to this excessive level of charge per session, and therefore missing out on health benefits, which will simply move costs to other areas of health and social care effectively.

I personally do not object to payment at a reasonable level of charge rate, relevant to duration of activity session etc, but I feel the proposed rate is at an excessive level for any user, and will financially exclude some service users from accessing the services and the benefits they bring.

As an alternative comparison, it is worth noting that the proposed charge of almost £20 for a 1 to 1.5 hour activity session, far exceeds the cost of attending private gym facilities which charges as follows :

Single one-off pay as you go session for £8 per session.

Weekly pass pay as you go for £25, which equals £5 per session if you go 5 days in that week.

I greatly appreciate all that the amazing staff at Dirrans Centre are doing for me, and I am deeply concerned that this totally excessive rate of charge as proposed will result in the service being effectively unavailable to service users, and will significantly impact on the level of service delivered by this incredible facility at Dirrans Centre Brain Injury Unit.

In context of all the above, I sincerely hope that this proposed rate of charge is not implemented at this excessive cost level, but that a  reasonable and sensible approach regarding charge level is taken on this matter.