Neighbourhood commissioning must deliver better outcomes for people and fairer work for careworkers
The Homecare Association has welcomed the Government's plans to move towards neighbourhood-based commissioning of homecare, announced by Minister of State for Social Care and Mental Health Alison McGovern MP at the National Children and Adult Services Conference.
The proposals will encourage local authorities to commission homecare across smaller geographical areas, with quality-assured providers serving each neighbourhood, each with enough hours to create compact rotas for careworkers and operate sustainably. The Government says this will help people build relationships with familiar careworkers, reduce travel time between visits and create more predictable working patterns.
Dr Jane Townson OBE, Chief Executive of the Homecare Association, said:
“We welcome the move to neighbourhood commissioning, which reflects what the Homecare Association has long argued: commissioning is the key to quality, fair work and better outcomes.
“To succeed, it must come with fees that cover the cost of care, predictable work and payment for whole rounds rather than contact minutes. People must also keep a real choice over who supports them.
“Done well, neighbourhood commissioning can mean familiar careworkers who know the people they support, less time on the road and more secure jobs. These relationships help careworkers spot changes early and keep people well at home. We look forward to working with government, councils and the NHS to develop guidance that puts these principles into practice.”
The Association recognises the potential of neighbourhood commissioning to improve continuity, make better use of the homecare workforce and strengthen the role of homecare within neighbourhood health services. This is not an argument for replacing small providers with a handful of large organisations. The relevant unit is the provider location, not the size of the parent organisation. A small local provider with a fair price, secure income, and compact geography can thrive; a large provider with scattered, below-cost work cannot.
Research into care rounds across six providers in Bristol, undertaken by Health Innovation Network South West, found that reorganising existing visits into geographical zones could potentially deliver the same care with 35% less staff time and 65% less driving. The purpose is not to reduce the workforce but to release scarce workforce capacity, so that more people can be supported while careworkers gain fuller, better-paid and more secure rounds.
Sheffield provides another practical example of what neighbourhood-based commissioning can achieve. Its Care and Wellbeing Service brings together 14 homecare providers across 16 geographical patches, supported by longer-term contracts and a more collaborative approach to service delivery. The model places greater emphasis on outcomes, workforce development and continuity, moving away from traditional time-and-task commissioning. It demonstrates how commissioning can create the conditions for more stable services, stronger local partnerships and better support for people in their own homes.
However, the Association emphasises that changing geographical boundaries alone will not address the underlying challenges facing homecare commissioning.
For neighbourhood models to succeed, commissioning arrangements must support financially sustainable services, provide sufficient and predictable volumes of work, recognise the full costs of delivering care and enable careworkers to be paid fairly for their working time.
It will also be important to ensure that people retain meaningful choice over their care and that local commissioning arrangements support a diverse, sustainable homecare market.
The Government has said it will work with local authorities over the coming months to track progress, with new guidance and toolkits expected in Spring 2027.
The Homecare Association looks forward to working with government, local authorities, the NHS and its members to help shape the guidance and ensure neighbourhood commissioning delivers lasting improvements for people drawing on care and those working in the sector.
Notes to editors
The Homecare Association represents over 2,100 organisations that provide homecare services across the UK. It works to ensure that people can access high-quality, sustainable care and support in their own homes.
Homecare Association report - Homecare: commissioning is the key to quality, fair work and better outcomes