Approaches to commissioning home care from the independent sector

Abstract

PurposeThis paper is the sequel to the authors' earlier paper in this journal and aims to present the “future research” outlined in that paper.Design/methodology/approachThe approaches being employed by Welsh local authorities in commissioning home care from the independent sector are surveyed to see how a mixed economy of care is being implemented. The observed differences are analysed to see what can be learnt for the benefit of public sector managers concerned with the development of commissioning practices. Semi‐structured interviews have been performed with home care managers and commissioning officers in 13 (60 per cent) of the local, unitary authorities in Wales. Managers at independent home care providers have been interviewed also. The study has been ongoing since September 2004. For comparison, Barnet in England has been included because, unlike any Welsh authority, it has implemented 100 per cent outsourcing of home care. Croydon has been included as it has a good practice brokerage that has helped it to expand its provision from the independent sector.FindingsGreat diversity is seen in the approaches adopted by the Welsh local authorities when commissioning home care from the independent sector. They differ in the proportion of home care that is commissioned from the independent sector, what is commissioned, the number of independent providers and the contractual arrangements. These features are used to develop a taxonomy of home care strategies that reveals high levels of diversity. It is seen that in Wales there has been less political drive and compulsion to outsource home care than in England, but the natural desire to reduce costs in the face of a growing need for home care is now driving outsourcing in Wales.Practical implicationsThis paper provides guidance to public sector managers in local authorities seeking best practice in the commissioning of home care from the independent sector.Originality/valueThe existing literature contains little research into good practice in the commissioning of home care by local authorities from the independent sector. This paper is a timely contribution to addressing this shortfall.