The Department of Health is considering plans for regional
commissioning of domiciliary services and residential nursing care
for older people.
The controversial proposal has been put forward by Sir Peter
Gershon, as part of his review of how to make public services more
efficient. The Treasury has asked the DoH whether procurement
agencies could be set up to buy home care services and beds in care
homes on behalf of several local authorities.
Fees would be set regionally and tendering processes standardised
across councils, doing away with the variations that currently
The Treasury believes this approach could make the process quicker
and cheaper for authorities, although Community Care
understands that the Department of Health is resistant to the idea.
A form of regional procurement already exists in some areas, with
local authorities forming consortia to buy IT solutions and office
equipment in bulk.
However, the proposals to extend the principle to care services
have been criticised by the Local Government Association and the
Association of Directors of Social Services.
ADSS president Andrew Cozens said local government had controlled
demand and kept the cost of services down since it began managing
older people’s care services 10 years ago.
“If this was done regionally it would almost certainly lead to
larger national providers dominating the market and costs
increasing,” he said.
But Fiona Street, acting chair of the UK Home Care Association,
said that if commissioning was streamlined to take into account
regional variations in staff availability, pay rates and ethnic
diversity there could be several benefits.
“Currently, there isn’t the consistency across authorities on the
tendering process and this causes problems for organisations
working across a number of local authorities.
“If this was standardised, we could save on administration, which
would take out overheads and allow us to keep the costs we charge
down,” she added.