Market shaping is not an activity undertaken just by local authority commissioners, says the Institute of Public Care’s Nic Rattle, and we need to recognise that.
Who shapes our care and support market? For many, market shaping is seen as a new duty under the Care Act resting with social care commissioners - tasked both to ensure a diverse, sustainable market and to understand and manage the risk of provider failure.
I think it is more than that. In the recent What is Market Shaping paper produced as part of the Market Shaping Review commissioned by the Department of Health in partnership with the LGA, ADASS and the Care Provider Alliance, we suggest that market shaping is a task for the public sector more widely, not just social care commissioners.
For example, within adult social care, social workers define the options available to people through assessment and can shape people’s expectations and aspirations, influencing take up of different types of care and support provision. What is this if not market shaping?
It is the whole local authority (not just the DASS) who has the duty to promote the efficient and effective operation of the care and support market. So procurement, economic development and planning teams for starters can all have a real impact on the market.
For example, the approach taken by planners will impact on the market for specialist housing for older people. Conversations are needed within local authorities about how to fulfil the duty at a broader level, at a more senior level and across different departments. People need to be conscious of the impact and influence they can have on the market, both positive and negative, and acknowledge that.
The actions of neighbouring local authorities can also shape the care and support market within a local authority. For example, many home care providers operate across local authority borders and are influenced by a range of market shaping (and procurement) activities that may conflict and compete. Actions by one local authority that affect their home care market can also have an impact on the care and support market available to another.
Of course, those shaping the care and support market stretch beyond the local authority. Health colleagues play an important part in influencing demand and supply of services, as well as purchasing some services from the same providers as local authorities.
For example, when a CCG will pay a higher fee rate than the local authority for the same care home bed, the preferences of those funded by the local authority come second to those funded by the CCG.
The recent requirement from NHS England to produce Sustainability and Transformation Plans (STPs) is an opportunity for areas to a take a co-ordinated view across health and social care about what the market should look like and how it could best meet outcomes for local communities.
The challenge of STPs is to be truly ambitious, focusing not just on efficiency but also long term effectiveness and better outcomes for the population through creative joint solutions. Efficient solutions that make a positive difference to people receiving care and support, with a workforce and providers able to deliver them.
If we’re honest with ourselves, we recognise the need for us all to work together in a much more mature way, most crucially involving both providers and people who receive care and support in a meaningful way. Shaping a diverse, sustainable market of viable and quality provision isn’t the responsibility of one individual or team, it’s down to all of us.
You can access the all materials produced as part of the Market Shaping Review here.