Decision details

Recommissioning of Homecare (Independence at Home) services

Decision Maker: Health and Care Board

Decision status: Approved

Is Key decision?: Yes

Is subject to call in?: Yes


A proposal for a framework approach to transform the care sector in B&NES, including the opportunity to take an integrated approach to homecare that supports people to live independently at home.


RESOLVED (unanimously) that the Health and Care Board agreed to:


1)  Ratify the proposals which were agreed by the Joint Commissioning Committee at its meeting of 25th April, 2019, and are detailed in section 2 of this report relating to:

a.  Endorsing the framework and ‘innovation contract’ approach to homecare and actions identified to progress this

b.  Interim contractual arrangements to promote continuity of service while the framework is developed

2)  Note related funding recommendations agreed to come from the integrated Better Care Fund by the Joint Commissioning Committee on 25th April 2019:

a.  An independent fair price of care analysis for homecare

b.  Specialist support to develop innovation pilots and transformation to outcomes based commissioning in homecare.

Reasons for the decision:

The balance of evidence suggests that a sustainable homecare sector for B&NES is most likely to be achieved by:

  • taking a flexible approach
  • valuing existing relationships
  • paying a fair (but controlled) price for care
  • making best use of available capacity and;
  •  raising the profile of the sector and workforce.


Crucially, these recommendations support an approach which maximises independence yet reduces overall demand on the health & care system alongside effective short term interventions such as reablement and development of strength-based social work practice.


Alternative options considered:

Continuing with existing arrangements would not be considered viable due to the interim nature of contractual arrangements and trading conditions in the private homecare sector.


Commissioners have researched a range of commissioning approaches in operation around the Country for homecare and services aimed at increasing people’s independence at home. Research included a range of national best practice guidance and learning events specialising in outcomes based commissioning and managing demand. Meetings were held with commissioners in other areas who are operating successful outcome-based models to assess the potential for applying those models to B&NES’s local circumstances.

Report author: Caroline Holmes

Publication date: 04/06/2019

Date of decision: 04/06/2019

Decided at meeting: 04/06/2019 - Health and Care Board

Effective from: 12/06/2019

Accompanying Documents: