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The Department of Health is considering a proposal for regional commissioning of domiciliary services and residential nursing care for older people, writes Derren Hayes.

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 beds in care homes and home care services on behalf of a number of different authorities.

Fees would be set regionally and tendering processes standardised across authorities, doing away with the variations that currently exist across councils. The Treasury believes this approach could make the process quicker and cheaper for authorities, although Community Care understands that the Department of Health is less keen on the ideas. 

A form of regional procurement already exists in some areas, with 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 the Association of Directors of Social Services.

Andrew Cozens, president of the ADSS, 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 added.

But Fiona Street, acting chair of the UK Home Care Association, said if commissioning was streamlined to take into account regional variations in staff availability, pay rates and ethnic diversity there could be a number of benefits.