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Market shaping

“It’s not a popular opinion, but the reality is we’ll only get good quality care if we work with the private sector and recognise that they need to make a profit, that is reasonable, transparent and affordable for customers and local government.”That’s the view of James Cawley, Wiltshire Council’s Associate Director for Adult Care Commissioning, Safeguarding and Housing.Five or so years ago, Wiltshire Council set out their vision for adult social care and started talking to service providers about what they wanted. Now, under the new duties set out in the Care Act 2014, all local authorities have to act likewise.Among other things, the Care Act places responsibilities on local authorities to make sure that people have information to make informed decisions, and have a choice of quality providers.A core part of the Act is the duty it places on care commissioners to facilitate and shape a vibrant, responsive and sustainable market of service providers. It must do that by:• focusing on outcomes and wellbeing• promoting quality services, including through workforce development and remuneration and ensuring appropriately resourced care and support• supporting sustainability• ensuring choice• co-production with partners.For local authorities, this represents a move away from merely providing services to instead meeting the needs of a wider population – and presents care commissioners with enormous challenges.For example, creating choice is not simply about working with more service providers, as inevitably this simply leads to more providers offering similar services and, therefore, competing only on price – it then becomes a race to the bottom.The Care Act calls on local authorities to have a thorough understanding of the care market: what services are available in their area and what the customers want – and, perhaps as important, don’t want.Equally, local authorities must tell service providers what they require – so they can understand the needs and offer innovative solutions. Only then can the customers’ demands be met.Returning to James Cawley at Wiltshire Council, he says working in partnership with providers is key.“We partially fund an organisation which brings together care providers so we can talk about are current challenges and also what the future of care looks like.“We can have transparent conversations – what is the real cost of care? What are reasonable profits? Can you work with other partnerships to work better?“We set out to develop services that moved away from zero-hours contracts and 15-minute visits to outcomes. By setting out our stall, service providers can understand the market and spot niches – and ultimately provide a good quality care service and make a profit for themselves.”The council works with four strategic providers to deliver care and support in people’s homes. The four providers are working together now on training and key workforce issues within Wiltshire.“It does take a long time for these changes to happen,” says James, “but we’re at the stage now where we have invested in care partnerships and as a result, have better, stronger relationships. Now, instead of falling out with service providers, we can agree to disagree – and move on towards a better solution.”


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