Emergent Homecare Models Are Shaping Care in England: An Ethnographic Study of Four Distinct Homecare Models.

Abstract

This chapter addresses the grand challenge of an aging society and the subsequent growing demand for in-home care for the elderly - often referred to as homecare. It examines how emergent homecare models in England differ from the "time and task" model and how they are shaping the care market. These models offer new approaches regarding what, how, and when care is delivered at home. Homecare providers face rising demand driven not only by population aging but also by market demand for personalized care, choice, continuity of care, and real-time availability. The landscape presents an opportunity for innovative models to become established, by offering a more inducing service design and value propositions that respond to customers' needs. Using the "business model canvas" to guide data collection, this study presents an ethnographic case analysis of four homecare organizations with distinct emergent homecare models. The study includes 14 months of field observation and 33 in-depth interviews. It finds that providers are becoming increasingly aware of evolving customer needs, establishing models such as the "uberization," "community-based," "live-in," and "preventative" described in the chapter. These models are becoming more pervasive and are mostly market-driven; however, some of their innovations are market shaping. The major innovations are in their value propositions, partnership arrangements, and customer segments. Their value propositions focus on well-being outcomes, including choice and personalization for care users; their workforces are perceived to be a major stakeholder segment, and their networks of partners offer access to complementary services, investments, and specialist knowledge.