Strategies for achieving best value in commissioned home care

摘要

Purpose - This paper seeks to address the question, "How can private home care providers compete and drive their businesses forward to deliver best value to the community?" Public sector managers in local authorities need this question answered so that they can provide their part of the solution, facilitating best value. Design/methodology/approach - A review was performed of relevant literature on the commissioning (outsourcing) of home care and of best value. This indicates that the future of home care services, taking into consideration commissioning and how best value will be achieved, has not been researched widely. Therefore, an exploratory approach to research was adopted here using in-depth analysis of a small number of particularly informative local authorities and private providers selected by purposive/judgemental (extreme and critical case) sampling. Personal contact was deemed necessary in order to perform an intensive investigation to pursue in-depth information. Findings - To improve value one can cut costs and/or increase quality. It is argued here that there is little immediate opportunity for private home care providers to cut costs and with fixed pricing substantial improvements in quality cannot be funded by increased prices or cost cutting elsewhere. To address this impasse, two solutions have been identified; increased economies of scale through consolidation in the marketplace and radical improvements in efficiency through the exploitation of information and communication technology (ICT). Both of these strategies have major ramifications for the "enabling local authority" taking actions to see best value delivered to its community. Research limitations/implications - This paper presents the findings of exploratory research. A more detailed study covering many more local authorities, private care providers and an international prospective will be conducted over the next two years. Practical implications - This paper provides timely guidance to public sector managers in local authorities and private home care providers seeking best value in home care through commissioning. Originality/value - Little has been found in the literature on strategies by which private home care providers can deliver best value, yet such strategies are needed urgently to achieve best value. This paper is a timely contribution to addressing this need.