UK care outsourcing rises despite quality concerns: Oxford

OXFORD, UNITED KINGDOM — A recent study from Oxford University has revealed a significant increase in the onshore outsourcing of social care services within England to private providers. 

This shift has resulted in 96% of residential care services being managed by private companies, marking a notable 20% increase since 2001.

For-profit dominance raises quality concerns

The study highlights that over 80% of children’s homes are now operated by for-profit companies, an increase of more than 20% since 2010. Despite their growing dominance, these providers often underperform compared to public and third-sector alternatives. 

Dr. Anders Bach-Mortensen, the study’s lead author, said, “Our analysis reveals a paradox in England’s social care: for-profit providers have grown to dominate the sector, operating over 80% of adult and children’s residential care services, even though they consistently underperform public and third sector provision.”

Involuntary closures highlight quality issues

Between 2011 and 2023, regulatory bodies such as the Care Quality Commission and Ofsted enforced 816 involuntary care home closures. 

Alarmingly, 98% or 804 of these closures involved for-profit care homes, underscoring significant concerns about the quality of care provided by these entities.

Impacts of onshore outsourcing of social care services

The onshore outsourcing of social care services in England has had significant impacts on the sector, with both advantages and disadvantages:

Disadvantages

1. Quality concerns: For-profit providers consistently underperform public and third-sector alternatives in quality ratings.
2. Geographical inequalities: For-profit providers tend to cluster in affluent areas for adult care and deprived areas for children’s homes, potentially exacerbating regional disparities.
3. Financial instability: The profit motive may lead to cost-cutting measures that affect care quality or provider stability.
4. Loss of public sector expertise: As public provision diminishes, valuable institutional knowledge and experience may be lost.
5. Reduced local authority control: Outsourcing can limit local authorities’ ability to manage and improve care services directly.

Advantages

1. Increased capacity: Private providers have expanded the number of available care placements, helping to meet growing demand.
2. Potential for innovation: Competition among providers can drive innovation in care practices and service delivery.
3. Cost savings: In some cases, outsourcing may lead to cost efficiencies for local authorities.
4. Economic contribution: The growth of private care providers has created jobs and contributed to local economies.

The findings suggest a pressing need for improved regulation and oversight to ensure that the quality and accessibility of care are not compromised as England continues to rely heavily on private sector involvement in its social care system. 

The study calls for a reevaluation of current policies to better balance efficiency with quality and equity in service provision.