How do you shape a market? Explaining local state practices in adult social care

Abstract

The Care Act 2014 gave English local government a duty to ‘shape’ local social care markets. Qualitative data from eight local authorities show that multiple care markets require shaping within a locality (e.g. older people’s residential care; domiciliary care; day opportunities for people with disabilities). Grid-group cultural theory can be used to explain patterns of local authority market shaping, based on a four-part typology of rules and relationships: procurement (high state control, weak relationships with providers); managed market (high state control, strong relationships with providers); open market (low state control, weak relationships with providers); partnership (low state control, strong relationships with providers).

Data shows that local authorities are using different types of market shaping in different parts of the market, and these are shifting over time. Challenges to the sustainability of the care system (funding cuts, workforce shortages, rising demand) are pulling local authorities towards high control approaches. These run counter to the Care Act’s emphasis on individual choice and control (most compatible with the open market), and co-production (most compatible with partnership). Some local authorities are experimenting with hybrids of these two low control approaches. However, the rival cultural biases of different types mean that hybrid approaches antagonise providers and risk further unsettling an unstable market.

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Speaker biography

Catherine Needham is Professor of Public Policy and Public Management at the Health Services Management Centre, University of Birmingham. She has published a wide range of articles, chapters and books for academic and practitioner audiences, many of them focused on social care or the public service workforce. Her most recent book was published by Springer in 2018 and entitled Reimaging the Public Service Workforce. She tweets as @DrCNeedham

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