Commissioning domiciliary care – an outcome-based approach

Posted on June 1st, by editor in Caring Times. No Comments

Domiciliary care is the only care service in which a rigid and inflexible approach is adopted by the vast majority of authorities to the commissioning (and contracting) of the service. The approach is based on the identification of the activities to be undertaken on each visit, the allocation of time that each activity should take, and the specification of the time of arrival and departure of the care worker. Why should such an approach be considered necessary for domiciliary care and not for the commissioning of any other care service? Three reasons may be identified and there well may be more: 1. When the NHS and Community Care Act was implemented in 1993, the provision of domiciliary care by the independent sector was still in its infancy and therefore viewed with suspicion. 2. The market was still dominated by in-house homecare services. 3. New technological systems for monitoring provision had still to be developed. Twelve years later these reasons no longer apply. So why is this approach no longer appro

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