Incentives and Deterrents to the Supply of Long-term Care for the Elderly in England: Evidence and Experience in Two Local Authorities

Stephen Allan,Robin Darton

doi:10.1017/s1474746421000403

Abstract

This article reports on a study assessing the incentives and deterrents to long-term care (LTC) supply in two local markets in England. The supply of LTC in many countries is facing the issues of rising demand, (lack of) workforce and the interaction of the public and private sectors. Findings from qualitative interviews of local council and provider stakeholders exploring barriers and enablers faced by LTC providers in two local authorities (LAs) are presented and discussed. The interviews provided insight in three main areas: staffing, demand and stakeholder relationships. Staffing, in particular, is crucial and we found that there are many difficulties for providers in maintaining their workforce. Consistent with previous research, we also found that public spending levels on LTC puts pressure on providers striving to maintain a good quality service, including improved remuneration of staff.

Highlights

In this article, we explore the incentives and deterrents to long-term care (LTC) supply in two local markets in England
Widespread reform of LTC has occurred in many countries, including England, largely in an attempt to address the challenges faced with an increasing demand for services (Pavolini and Ranci, 2008)
Research has examined LTC supply from the policy (e.g. Needham et al, 2018; Glasby et al, 2020) and employee perspective (e.g. Hussein, 2017; Read and Fenge, 2019). It is in this context that we report the findings from a study assessing the incentives and deterrents to LTC supply for two local authorities (LAs) in England using stakeholder interviews

Summary

Introduction

We explore the incentives and deterrents to long-term care (LTC) supply in two local markets in England. In England, privatisation of LTC delivery occurred during the 1980s and throughout the 1990s, which led to a growth in care home supply from the independent sector (Knapp et al, 2001). Care home supply has remained fairly stable over the last decade, with around 450,000 beds available for the elderly in the LTC sector (LaingBuisson, 2015). There has been a fall in beds over time relative to the elderly population and the availability of care home places varies across the country, due to local need and socioeconomic characteristics, supply conditions (e.g. labour supply), and local government policy (Allan and Nizalova, 2020). The care homes market remains competitive overall, with most of the population within range of a selection of care homes (Forder and Allan, 2014; Competition and Markets Authority, 2017)

Methods

Findings

Discussion

Conclusion