The ‘commoditisation of care’ for older people

A blurring of boundaries between different sectors coupled with changes to funding for care organisations have led to the development of a ‘marketplace of care’. This ‘commoditisation of care’ is likely to continue to increase in the future, with more and more services being provided by an ever increasing range of organisations from all sectors.

The previous government proposed the ongoing personalisation of care in the document “Putting People First”, aiming for 30% of council-funded care users to have personal budgets by April 2011. The Coalition government is in favour of personal budgets and has maintained this target. These personal budgets set up a complex set of new challenges.


  • Increased role in public services for VCOs, (particularly those harnessing volunteer labour) as they are expected to meet many gaps with the cost of care likely to exceed what the government can afford in a recession.
  • Increasing pressure to demonstrate efficiency and value for money.
  • An increasing number and range of services can increase the choice of services available to older people.
  • Competition between providers can lead to higher quality and more relevant care services.
  • Higher expectations of older people’s services in terms of quality and the way in which they are delivered.
  • Increased competition could lead to reduced costs for popular care services which may ease levels of poverty and inequality amongst older people.
  • Pressure to implement standardised procedures and services due to theincreasing range of providers and services may lead to tension with the personalisation agenda.
  • Risk that care and caring becomes too commercialised and less human based leaving older people increasingly vulnerable.
  • Different “need groups” (e.g. old age, learning disability, physical disability) may have distinct challenges, with larger or more vocal groups prioritised when planning the commissioning system.

Moving forward

The provision of care will change as commoditisation continues.

  • Are there opportunities to influence the commissioning process to ensure it is fair both to front line providers and to end-users of the service?
  • Can your organisation influence commissioners and other health professionals by raising awareness of the need for new models for care?
  • Will less cost-effective niche services be threatened by the changes?
  • Are you adequately prepared for changes in procurement and commissioning?
  • Can your organisation ensure end-users have adequate information on services and on how to manage their personal budget?
  • Can your organisation ensure that it provides an adequate amount of training for carers in caring roles?

Want to know more?

Options for care funding: What could be done now?

Published by:Joseph Rowntree Foundation



What is it?A summary that updates a Solutions produced in 2007, and suggests four costed, fairer and more sustainable methods of funding.

Personal Best

Link: Personal Best

Published by: Demos, think tank aiming to “give a voice to people and communities”

Date: October 2010

Format: PDF

What is it? A substantial report examining the key concerns regarding commoditised care, in particular giving details on what is required by the public and on the various challenges involved in meeting these needs through a market system. It is based on a survey of 770 care users across ten local authorities. Follow-up reports are also planned.

How useful is this? The report itself is long and detailed but a thorough executive summary provides a good introduction to the key ideas. Several key challenges are identified, including: affordability; lack of consumer information; and providers being unprepared for the diverse changes. Another challenge is that personal budgets would open up more diverse preferences than the current system allows, suggesting that the debate is not simply about the most cost-effective provision of a specific well-defined service.

Other comments: The earlier Demos reportAt your service may also be of interest.

Careless: funding long-term care for the elderly

Published by: Policy Exchange, a centre-right think tank with a focus on strong communities

Date: 2010

Format: PDF

What is it? This is a 41 page report focused on care for the elderly, including useful data on the costs of care provision. It also outlines a range of policy proposals.

How useful is this? As well as providing another perspective on the discussion around commoditised care, this report grounds the debate with data on the actual costs of long term care and on who is currently bearing these costs.

Expectations and aspirations: public attitudes towards social care

Published by: IPPR, a left-of-centre think tank

Date: 2010

Format: PDF

What is it? This is a report on the public attitudes towards social care and as such gives a useful  context for the ongoing commoditisation. It is based on a survey of nearly 2000 individuals in April 2009.

How useful is this? This gives a broad analysis of public attitudes to long term care, including themes such as the lack of awareness, reluctance to increase the burden of informal care and a strong desire to learn more and engage with the debate.

Other comments: A more recent IPPR document “When I'm 94” gives a succinct overview of the public's key concerns regarding a social care system.

Options for care funding: What could be done now?

Published by: JRF (Joseph Rowntree Foundation), a charity devoted to understanding and solving social problems


Format: PDF

What is it? A summary that updates a 2007 Solutions document and suggests four costed, fairer and more sustainable methods of funding.

How useful is this? This gives a useful account of the broader policy environment, suggesting alternative methods of funding.

Other comments: Another older JRF report provides a useful international comparison: Funding long-term care for older people: Lessons from other countries.

A new measure that will shake up adult social care

Published by: The Guardian, a left-of-centre broadsheet

Date: June 2010

Format: Web article

What is it? An article outlining a method for assessing social care services.

How useful is this? This gives a brief and accessible discussion of one aspect of the wider debate, namely on how to compare services. The reader comments “below the line” also provide an insight into broader attitudes on social care, although naturally should not be taken as representative.

Last updated at 14:03 Mon 10/Jan/11.

Recent comments

Kathryn's picture


Third Sector Foresight

Recent research from Counsel and Care has revealed some potentially worrying trends. In particular, that

64% said they had not even thought about how to fund their own care

could be storing up issues for the future. The move towards a market for care, such as identified in this driver and others (see personalisation of care for example) pushes the focus onto economic issues. So for over half the population to have not given it a thought, there could be trouble ahead. What can organisations do to help people with this? Perhaps some events to educate people about options? The research also showed that most people (69%) turn to the internet for information on care for older people, followed by GP surgeries (58%) and local council or social services (52%).

If you'd like to read more on the research, follow this link.

Megan 's picture


Third Sector Foresight

I've just uploaded some new sources of further information in the 'want to know more?' section of this driver - happy reading!

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