How do you Shape a Market? Explaining Local State Practices in Adult Social Care

Catherine Needham,Jon Glasby,Melanie Henwood,Sarah Carr,Catherine Mangan,Kelly Hall,Kerry Allen,Steve Mckay,Hareth Al-Janabi,Emily Burn,Warda Tahir

doi:10.1017/s0047279421000805

Abstract

AbstractThe Care Act 2014 gave English local authorities a duty to ‘shape’ social care markets and encouraged them to work co-productively with stakeholders. Grid-group cultural theory is used here to explain how local authorities have undertaken market shaping, based on a four-part typology of rules and relationships. The four types are: procurement (strong rules, weak relationships); managed market (strong rules, strong relationships); open market (weak rules, weak relationships); and partnership (weak rules, strong relationships). Qualitative data from English local authorities show that they are using different types of market shaping in different parts of the care market (e.g. residential vs home care), and shifting types over time. Challenges to the sustainability of the care system (rising demand, funding cuts, workforce shortages) are pulling local authorities towards the two ‘strong rules’ approaches which run against the co-productive thrust of the Care Act. Some local authorities are experimenting with hybrids of the two ‘weak rules’ approaches but the rival cultural biases of different types mean that hybrid approaches risk antagonising providers and further unsettling an unstable market.

Highlights

IntroductionThe Care Act aimed to improve care services through a range of approaches, including assigning local government in England a duty to ‘shape’ the care market
Local authority interviewees frequently talked about the difficulties of generalising about their care markets, which militated against a unified approach to market shaping: It’s very difficult to think across the whole picture, isn’t it? We’ll end up with: market shaping for home care looks like this and your assets-based community shaping looks like that, but it’s so difficult to bring it all together. (Site, local authority INT )
Self-funders are not included in the analysis: we found that they remained peripheral to local authority market shaping, despite the intentions of the Care Act (Henwood et al, )

Summary

Introduction

The Care Act aimed to improve care services through a range of approaches, including assigning local government in England a duty to ‘shape’ the care market. Market shaping extended the existing commissioning role of local government to give responsibility to ‘promote the efficient and effective operation of a market in services for meeting care and support needs’, including for people who fund their own care (HM Government, , Section ( )). : : : [engaging] with stakeholders to develop understanding of supply and demand and : : : based on evidence, to signal to the market the types of services needed and in the future to meet them, encourage innovation, investment and continuous improvement The market-shaping duty includes a requirement to enable personalised support for people using services and co-production with partners in line with the broader principles of the Care Act (DH, )

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Results

Discussion

Conclusion