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Title: Operations strategy in home care
Author: Davies, Bethan Mair
ISNI:       0000 0001 3410 2986
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2006
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Local government authorities in England and Wales are moving towards increasing levels of commissioning from the independent sector (outsourcing) in the provision of home care. This has been and continues to be driven politically in the first instance but is also a response to general market forces. This change is altering the role of the local authority in the provision of home care although the precise nature of the new role needs to be established. Local authorities must formulate commissioning strategies to deliver best value. Clearly, the role of the local authority is moving away from the operational level dealing with the direct provision of services towards the strategic level and high-level supervisory control. Public sector managers now need intelligence and guidance to help them in the formulation of home care commissioning strategies and mechanisms. This thesis addresses this need. To gather intelligence, interviews are conducted with the social services departments of 15 local authorities. Since one of the intentions is to determine those strategies that have emerged under the UK Government's Best Value regime implemented in 2000, without the legacy of the purer compulsion experienced in England in the 1990s, 13 of the local authorities are in Wales. Two cases in England that have particularly high levels of outsourcing are included in the detailed survey. Complementary evidence is taken from several other local authorities in England and from various other public bodies. 12 independent providers of home care are interviewed. Evidence is also taken from the literature including UK Government and Welsh Assembly sources. It is identified that there is great diversity in the approaches adopted when commissioning (outsourcing) home care from the independent sector. They differ in the proportion of home care that is commissioned from the independent sector, what is commissioned, the number of independent providers and the contractual arrangements. These features are used to develop a taxonomy of home care strategies that reveals high levels of diversity. The relative merits of the commonly used spot, block and cost-volume contracts are also considered. Six fundamental strategies for achieving a mixed economy of home care are synthesised from the survey. These options are based on complementary capacity and/or capabilities. The seventh option is 100% outsourcing. Conclusions are drawn on the future prospects of these strategies in the face of government regulation and inspection. In considering the new role of the local authority, it is seen that it must enable the development of the independent sector to ensure choice and competition and to allow the development of 'healthy' providers that can deliver best value to the community. As outsourcing is well established as a central component of operations strategy in the manufacturing sector, the practices adopted there are considered to identify lessons that might be learned by public sector managers, especially those concerned with outsourcing home care.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral