Councils will be encouraged to commission home care across smaller geographical areas, with one or two main providers serving each neighbourhood, in a new UK Government announcement. 

The Department of Health and Social Care believes this will ensure people receiving care at home can build consistent, familiar relationships with the same carers.

It cited research by the Health Innovation Network (HIN) South West that found reorganising existing visits into geographical zones could potentially deliver the same care with 35% less staff time and 65% less driving.

This underpins the government's aim to reform social care so it improves quality and efficiencies while delivering the ambition of the 10-Year Health Plan to shift care from hospitals to the community.

New guidance and toolkits will be published in the spring to support councils in making the transition, as part of the government's broader ambition to lay the foundations for a National Care Service.

James Arrowsmith, Partner specialising in social care at UK and Ireland law firm Browne Jacobson, said: “Transitioning the commissioning of homecare to a focus on localities is a step in a journey to a more neighbourhood-based system. This would support a wider ambition to build systems that engage and empower communities, and the people within them, to have greater agency over their lives and their support.

“These are themes that have emerged clearly in Baroness Casey's ongoing review of adult social care, and they were echoed in remarks by Minister for Social Care, Alison McGovern, to directors of adult services. The HIN South West research cited in the announcement provides compelling evidence of the benefits for commissioners, providers and the workforce alike.

“The government has been careful to frame this as an encouragement at this stage, with new guidance and toolkits promised in the spring. That is sensible. But given the clear steer from the minister to directors that they should be moving forward now – not waiting for central government to tell them what to do – councils would be wise to begin preparing. Those expectations are likely to harden over time.

“That said, the practical challenges of making this transition should not be underestimated. Current commissioning arrangements, procurements, contracts and allocation systems have been built around a different model, and providers have shaped their offers accordingly. Councils will need to work closely with their social care leadership and legal teams to understand what is achievable within their existing frameworks and what a transition programme might look like. This is not simply an operational question, but has real legal and commercial dimensions.

“Capacity is also unlikely to be evenly distributed. Homecare ‘cold spots’ will almost certainly emerge, particularly in large rural areas, and ambitious councils may want to think now about how development of provision in those areas can be supported as part of any transition programme.

“It will also be essential to keep personalisation at the heart of this reform. The concern raised about the impact on direct payments and personal assistants is legitimate, and where strong, effective relationships already exist between people accessing care and their carers, those relationships should be prioritised. In some cases, to do otherwise could carry real risk for those individuals.

“One further note of caution: the efficiency figures in the HIN South West research may generate expectations of immediate cost savings. This reform is first and foremost about improving quality of care and removing costs that do not support outcomes, such as excessive travel time. Commissioners and their colleagues should be prepared to manage any expectations of savings carefully, while making the case for how change can improve quality and support reinvestment in care.

“The legal and commercial tools to begin this transition already exist. Commissioners and their legal advisers have an important role to play in helping their social care colleagues understand the possibilities and constraints of current arrangements, and in working constructively with providers to explore how change can be achieved. This announcement – and the evidence base behind it – provides a valuable platform for those conversations, even before the spring guidance arrives.”