This paper examines the background to the complex relationships between commissioners, users and providers of residential and domiciliary social care, to establish the context in which further development – or ‘facilitation’ – of the social care market will take place.
After briefly exploring the policy background to the current mixed economy in social care, it assesses the roles of the key players in shaping the market, including:
- the evolution of the local authority role from purchasing to commissioning, with its greater emphasis on planning and stimulating a diverse market in the long term, rather than managing placements day-to-day;
- the rise of private sector provision, the increasing role of voluntary and social enterprise providers, and factors militating against further plurality of supply; and
- the likely influence – and limits on influence – of service users in shaping the future direction of the market in an era of individual budgets and self-directed care.
Having surveyed the market as it now stands, the paper sets out the challenges it faces in the coming years, including establishing more constructive commissioner-provider links, ensuring joint working between local authority departments and across local authority boundaries, and shifting the emphasis from inputs and processes to meeting agreed outcomes for service users.
Finally, it examines potential obstacles such as demographic changes, financial constraints in the aftermath of the banking crisis, and the demand for personalisation of services, and proposes possible solutions.
