The commissioning cycle: Commissioning home care for older people

Talking to staff and service users and commissioners, we realised that people did not necessarily want a five-day-a-week service in place, they wanted different activities and they wanted some form of activities out and about, out in the community, away from the day service.

Service manager [8]

To improve the quality and value of services, commissioners should look at all areas of the commissioning cycle – from assessment through planning and delivery to review. It has been found that commissioners sometimes focus most on the buying of services and less on other stages of the process that have been found to be just as important. [8] Commissioners may benefit from training to understand the strategic nature of their role. [8]

The growing numbers of older people with complex needs, combined with severe budget constraints, mean that commissioners have to think creatively about how to commission home care that:

• makes it possible for people to remain in their own homes
• protects their dignity
• protects their human rights
• reduces unnecessary admissions to hospital
• improves users’ and their unpaid carers’ quality of life.

Growing evidence of what service users and their unpaid carers want and what the best home care looks like shows that the following are important, so commissioners to think about:

• commissioning that is based on evidence
• commissioning that incentivises providers to achieve defined outcomes
• having a diverse range of service providers
• all staff involved joining forces and working as a team.

Evidence suggests how commissioners can improve their practice in each area of the commissioning cycle.