Table of Contents
Executive Summary
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- Market size
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- Figure 1: UK Market for Domiciliary Care, 2011/12-2015/16, (£ Million)
- Figure 2: Segmentation of the UK Market Domiciliary Care, by Type of Purchaser, 2011/12-2015/16, (£ Million)
- Market trends
- Old age support ratio projected to fall
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- Figure 3: UK Population Projections, by Age Group, 2016-2040, (Million People)
- Rising gap between costs and fees are affecting service provision...
- ...which is also applying greater pressure on the sector’s workforce
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- Figure 4: Annual Workforce Turnover Rates in the Independent and Voluntary Domiciliary Care Sector, England, 2015 and 2016, by Employee Position, (%)
- CQC inspections find vast range in quality of service provision
- Regional analysis
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- Figure 5: Number of Domiciliary Care Service Users per 10,000 Adults, by Region, 2010/11-2014/15, (No. Of Clients per 10,000 adults)
- Market factors
- Ageing population and pension changes will increase strain on service provision and care affordability
- Care fee and cost funding gap has widened due to implementation of higher minimum and living wages
- The consumer
- Close to three-quarters of people have not thought about how they would pay for care
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- Figure 6: Domiciliary Care Payment Plans, June 2016, (% of Respondents)
- People expect to use personal savings and pension income to fund care
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- Figure 7: Domiciliary Care Payment Method, June 2016, (% of Respondents)
- Carer selection and time duration determine choice
- Opinion of current home care users weighs heavy on agency choice
- Financial concerns impact desirable care preferences
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- Figure 8: Domiciliary Care Service Preferences, June 2016, (% of Respondents)
- Companies
- Affordability concerns leading to changes to, and even termination of, service contracts
- Allied Healthcare retains position as market-leading service provider
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- Figure 9: Independent Sector Domiciliary Providers’ Market Share, 2016, (% of Total Independent Sector Market)
- Forecast
- Sluggish growth expected in the market over the next five years
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- Figure 10: Forecast UK Domiciliary Care Market Value, 2016/17-2020/21, (£ Million at 2016 prices)
- Informal care expected to continue to reduce the burden placed on formal care providers in the light of a growing number of care users with intensive care needs
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- Figure 11: Forecast UK Domiciliary Care Market Segmentation Value, by Type, 2016/17-2020/21, (£ Million at 2016)
- What we think
Key Insights
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- Does the sector still require a ‘cost cap’?
- Will the 2% council tax precept be enough to fill the care funding gap?
- Are domiciliary care providers doing enough to offer suitable care for those with the most intensive needs?
- What does the future hold for domiciliary care?
Introduction
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- Definitions
- Methodology
- Abbreviations
- Market positioning
UK Economy
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- Key points
- Overview
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- Figure 12: UK GDP, 2005-2015, (% Quarterly Growth and GDP in £ Billion)
- Figure 13: UK Output, by Industry, 2008-2016, (Index 2012 = 100)
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- Figure 14: Quarters after GDP Peak, 1979, 1990 and 2008, (Number of Quarters and GDP as % of PreDownturn Peak)
- Inflation
- Interest rates
- House prices
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- Figure 15: UK House Price changes, 2004-2016, (12-month % change)
- Consumer spending
- Manufacturing
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- Figure 16: UK Manufacturing, 2013-16, (Index, 2012 = 100)
- Business investment
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- Figure 17: UK GFCF 2003-15, (£ Million)
- Imports
- Exports
Market Factors
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- Key points
- Ageing population, alongside pension changes, will increase strain on service provision and care affordability
- Care fee and cost funding gap has widened due to implementation of higher minimum and living wages
- High profile care scandals highlight growing pressure on the sector
- ‘Brexit’ could lead to further staff turnover pressures
- Other factors
- NICE guidelines
- CQC regulatory fees
- Legislation
- Community Care Act
- Care Standards Act
- Regulation and Inspection Bill (Wales)
- The Care Act 2014 and Better Care Fund
- Market oversight
- Care Certificate
- Pensions Act
- The Carers’ Strategy
- Other legislation
Market Size
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- Key points
- England
- Wales
- Scotland
- Northern Ireland
- UK
- Market value
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- Figure 18: UK Market for Domiciliary Care, 2011/12-2015/16, (£ Million)
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- Figure 19: UK Market for Domiciliary Care, 2011/12-2015/16, (£ Million)
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- Figure 20: UK Commercial Market for Domiciliary Care, 2011/12-2015/16, (£ Million)
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- Figure 21: UK Commercial Market for Domiciliary Care, 2011/12-2015/16, (£ Million)
Market Segmentation
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- Key points
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- Figure 22: Segmentation of the UK Domiciliary Care Market, by Type of Purchaser, 2011/122015/16, (£ Million)
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- Figure 23: Segmentation of the UK Domiciliary Care Market, by Type of Purchaser, 2011/12-2015/16, (£ Million)
Local Authority Expenditure
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- Key points
- Older people (65+)
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- Figure 24: Segmentation of Local Authority Expenditure on Domiciliary Care for Older People (65+) in the UK, by Type, 2010/11-2014/15, (£ Million)
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- Figure 25: Segmentation of Local Authority Expenditure on Domiciliary Care for Older People (65+) in the UK, by Type, 2010/11-2014/15, (£ Million)
- Adults aged 18-64
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- Figure 26: Segmentation of Local Authority Expenditure on Domiciliary Care for Adults aged 18-64 in the UK, by Client Type, 2010/11-2014/15, (£ Million)
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- Figure 27: Segmentation of Local Authority Expenditure on Domiciliary Care for Adults aged 18-64 in the UK, by Client Type, 2010/11-2014/15, (£ Million)
- Figure 28: Segmentation of UK Local Authority Expenditure on Domiciliary Care, All Adults, by Client Type, 2010/11-2014/15, (%)
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- Figure 29: Segmentation of UK Local Authority Expenditure on Domiciliary Care, all adults, by Client Type, 2010/11 and 2014/15, (%)
- Figure 30: Number of Contact Hours of Home Care Provided in the UK, by Sector and Country, 2011/12-2015/16, (Million hours)
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- Figure 31: Number of Contact Hours of Home Care Provided in the UK, by Sector, 2011/12-2015/16, (Million Hours)
- Figure 32: Number of Domiciliary Care Service Users, by Region, 2010/11-2014/15, (Thousands)
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- Figure 33: Number of Domiciliary Care Service Users per 10,000 Adults, by Region, 2010/11-2014/15, (No. Of Clients per 10,000 adults)
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- Figure 34: Number of Domiciliary Care Service Users per 10,000 Adults, by Region, 2010/11 and 2014/15, (No. of Clients per 10,000 adults).
- Figure 35: Local Authority Expenditure, All Adults, by Region, 2010/11-2014/15, (£ Million)
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- Chart 32: Local Authority Domiciliary Care Expenditure for All Adults, by Age Category, 2010/11-2014/15, (£ Million)
- Figure 36: Local Authority Expenditure, Older People (65+), by Region, 2010/11-2014/15, (£ Million)
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- Figure 37: Local Authority Expenditure, Older People (65+), 2010/11 and 2014/15, (£ Million)
- Figure 38: Local Authority Expenditure, Adults (18-64) with Physical or Sensory Disabilities, by Region, 2010/11-2014/15, (£ Million)
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- Figure 39: Local Authority Expenditure, Adults (18-64) with Learning Disabilities, by Region, 2010/11-2014/15, (£ Million)
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- Figure 40: Local Authority Expenditure, Adults (18-64) with Mental Health Needs, by Region, 2010/11-2014/15, (£ Million)
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- Figure 41: Local Authority Expenditure, All Adults (18-64), by Region, 2010/11-2014/15, (£ Million)
- Government spending pledge may not be sufficient to plug funding gap
- Growing trend away from formal care provision
NHS Expenditure
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- Key points
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- Figure 42: Segmentation of NHS Expenditure on Social Care Community Services, by Country, 2011/12-2015/16, (£ Million)
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- Figure 43: Segmentation of NHS Expenditure on Social Care Community Services, by Country, 2011/12 and 2015/16, (% of Total)
High Tech Domiciliary Care
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- Key points
- Telecare and telemedicine market development
- Industry association ensuring standards and service quality remains high
Private Expenditure
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- Key points
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- Figure 44: Segmentation of Private Expenditure on Domiciliary Care in the UK, by Type, 2011/12-2015/16, (£ Million)
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- Figure 45: Segmentation of Private Expenditure on Domiciliary Care in the UK, by Type, 2011/12-2015/16, (£ Million)
- Figure 46: Estimated Size of the Self-Funded Home Care Market, by Client Type, 2015/16, (in Units, Hours, Million Hours and £ Million)
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- Figure 47: UK Domiciliary Care Self-Funders, by Region, 2015, (Hours Purchased, Expenditure and Number of People)
Informal Care
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- Key points
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- Figure 48: Informal Carers by Relationship to Person Receiving Care in England, 2011/12-2014/2015, (% of Informal Carers)
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- Figure 49: The UK Market for Informal Domiciliary Care, 2011/12 - 2015/16, (£ Billion and Hours)
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- Figure 50: UK Market for Informal Domiciliary Care, 2011/12-2015/16, (£ Billion and billion hours)
Market Trends
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- Key points
- Old age support ratio projected to fall
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- Figure 51: UK Population Projections, by Age Group, 20162040, (000 people)
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- Figure 52: Estimated and Projected Age Structure of the United Kingdom Population, by Sex, Mid-2016 and Mid-2040, (Thousands)
- Rising gap between costs and fees are affecting service provision...
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- Figure 53: Estimated Minimum Price for Home Care, 2016, (£)
- ...that is also applying greater pressure on the sector’s workforce
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- Figure 54: Annual Workforce Turnover Rates in the Independent and Voluntary Domiciliary Care Sector, England, 2015 and 2016, by Employee Position, (%)
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- Figure 55: Annual Workforce Turnover Rates in the Independent and Voluntary Domiciliary Care Sector, England, 2015 and 2016, by Employee Position, (%)
- Figure 56: Average Annual Pay in the Independent and Voluntary Domiciliary Care Sector, England, 2015 and 2016, by Employee Position, (£)
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- Figure 57: Average Annual Pay in the Independent and Voluntary Domiciliary Care Sector, England, 2015 and 2016, by Employee Position, (£)
- CQC inspections find vast range in quality of service provision
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- Figure 58: CQC Inspection Outcomes, England, 1 October 2014 - 1 April 2016, (Rating and % of Registered Locations Inspected)
Regional Analysis
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- Key points
- England
- North East
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- Figure 59: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the North East of England, by Authority, 2010/11-2014/15, (£000)
- North West
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- Figure 60: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the North West of England, by Authority, 2010/11-2014/15, (£ 000)
- Yorkshire & the Humber
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- Figure 61: Analysis of Local Authority Domiciliary Care Expenditure on Older People in Yorkshire & The Humber, by Authority, 2010/11-2014/15, (£000)
- East Midlands
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- Figure 62: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the East Midlands by Authority, 2010/11-2014/15, (£000)
- West Midlands
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- Figure 63: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the West Midlands, by Authority, 2010/11-2014/15, (£000)
- South West
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- Figure 64: Analysis of Local Authority Domiciliary Care Expenditure on Older People in South West England, by Authority, 2010/11-2014/15, (£000)
- East of England
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- Figure 65: Analysis of Local Authority Domiciliary Care Expenditure on Older People in East of England, by Authority, 2010/11-2014/15, (£000)
- London
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- Figure 66: Analysis of Local Authority Domiciliary Care Expenditure on Older People in London, by Authority, 2010/11-2014/15, (£000)
- South East
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- Figure 67: Analysis of Local Authority Domiciliary Care Expenditure on Older People in the South East of England, by Authority, 2010/11-2014/15, (£000)
- Scotland
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- Figure 68: Domiciliary Care Clients in Scotland, by Client Type and Authority, 2014/15, (Number of Clients)
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- Figure 69: Domiciliary Care Clients in Scotland, by Client Type and Authority, 2015/16, (Number of Clients)
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- Figure 70: Distribution of Home Care Hours per week in Scotland, 2014/15, by Time Band and District, (% of Clients)
- Figure 71: Distribution of Home Care Hours per week in Scotland, 2015/16, by Time Band and District, (% of Clients)
- Wales
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- Figure 72: Number of Domiciliary Care Clients Aged 65+ in Wales, 2010/11-2014/15, by Local Authority, (Number of Clients)
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- Figure 73: Number of Domiciliary Care Clients Aged 18-64 in Wales, 2010/11-2014/15, by Local Authority, (Number of Clients)
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- Figure 74: Local Authority Domiciliary Care Expenditure in Wales, by Local Authority, 2010/11-2014/15, (£000)
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- Figure 75: Hours of Home Care Provided in Wales, by Local Authority, 2010/11-2014/15, (000 Hours)
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- Figure 76: Percentage of Home Care Hours Contracted to the Independent Sector, by Local Authority, 2010/11-2014/15, (% of Home Care Hours)
- Northern Ireland
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- Figure 77: Number of Clients Receiving Domiciliary Care in Northern Ireland, by Sector and HSC Trust, 2014/15, (Number of Clients during Survey Week)
- Figure 78: Number of Clients Receiving Domiciliary Care in Northern Ireland, by Sector and HSC Trust, 2015/16, (Number of Clients during Survey Week)
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- Figure 79: Number of Home Care Hours Provided per Week, by Sector and HSC Trust, 2014/15, (Number of Hours Provided during Survey Week)
- Figure 80: Number of Home Care Hours Provided per Week, by Sector and HSC Trust, 2015/16, (Number of Hours Provided during Survey Week)
The Consumer – Care Payment
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- Key points
- Close to three-quarters of people have not thought about how they would pay for care
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- Figure 81: Domiciliary Care Payment Plans, June 2016, (% of Respondents)
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- Figure 82: Domiciliary Care Payment Plans, June 2016, (% of Respondents)
- Young most likely to have not considered financial consequences of care
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- Figure 83: Domiciliary Care Payment Plans, by Age and Gender, June 2016, (% of Respondents)
- People expect to use personal savings and pension income to fund care
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- Figure 84: Domiciliary Care Payment Method, June 2016, (% of Respondents)
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- Figure 85: Domiciliary Care Payment Method, June 2016, (% of Respondents)
The Consumer – Service Choice
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- Key points
- Carer selection and time duration determine choice
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- Figure 86: Domiciliary Care Service Choice Factors, June 2016, (% of Respondents)
- Opinion of current home care users weighs heavy on agency choice
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- Figure 87: Domiciliary Care Agency Choice Factors, June 2016, (% of Respondents)
The Consumer – Care Service Preferences
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- Key points
- Financial concerns impact desirable care preferences
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- Figure 88: Domiciliary Care Service Preferences, June 2016, (% of Respondents)
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- Figure 89: Domiciliary Care Service Preferences, June 2016, (% of Respondents)
- Older people favour increased support for informal carers
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- Figure 90: Domiciliary Care Service Preferences, by Age and Gender, June 2016, (% of Respondents)
Industry Structure
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- Key points
- Industry development
- Services are now largely delivered by independent sector providers
- Cost pressures affecting M&A activity
- Affordability concerns leading to changes to, and even termination of, service contracts
- Increasing regulatory presence aims to improve industry conduct
- Allied Healthcare retains position as market-leading service provider
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- Figure 91: Independent Sector Domiciliary Care Providers’ Market Share, 2016, (% of Total Independent Sector Market)
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- Figure 92: Independent Sector Domiciliary Providers’ Market Share, 2016, (% of Total Independent Sector Market)
- 2015 saw an increase in the number of businesses operating more local units
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- Figure 93: Analysis of the Changes in the Structure of the ‘Other Human Health Activities’ Industry, 2011-2015, (Number of Local Units and Businesses)
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- Figure 94: Analysis of the Changes in the Structure of the ‘Social Work Activities Without Accommodation for the Elderly and Disabled’ Industry, 2011-2015, (Number of Local Units and Businesses)
- Structure by employment
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- Figure 95: Analysis of the Employment Structure of the ‘Other Human Health Activities’ Industry, 2014 and 2015, (Number of Local Units and Local Unit Employment Size)
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- Figure 96: Analysis of the Employment Structure of the ‘Social Work Activities Without Accommodation for the Elderly and Disabled’ Industry, 2014 and 2015, (Number of Local Units and Local Unit Employment Size)
- Structure by turnover
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- Figure 97: Analysis of the Financial Structure of the ‘Other Human Health Activities’ Industry, 2014 and 2015, (£ 000 and % of Total Turnover)
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- Figure 98: Analysis of the Financial Structure of the ‘Social Work Activities Without Accommodation for the Elderly and Disabled’ Industry, 2014 and 2015, (£ 000 and % of Total Turnover)
Company Profiles
Allied Healthcare (now part of Aurelius Group)
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- Figure 99: Financial Analysis of Acromas Holdings, 2011-2015, (£ Million)
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- Figure 100: Financial Analysis of Allied Healthcare Group, 2011-16, (£ Million)
- Company strategy
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BUPA Home Healthcare
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- Figure 101: Financial Analysis of BUPA Home Healthcare, 2011-15, (£ Million)
- Company strategy
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Chrysalis Community Care
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- Figure 102: Financial Analysis of Chrysalis Community Care Group, 2011-16, (£ 000)
- Company strategy
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Housing & Care 21
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- Figure 103: Financial Analysis of Housing & Care 21 (formerly Housing 21), 2011-2015, (£ Million)
- Company strategy
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Interserve Healthcare (formerly Advantage Healthcare)
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- Figure 104: Financial Analysis of Interserve, 2010-2014, (£ 000)
- Company strategy
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Mears Group
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- Figure 105: Financial Analysis of Mears Group, 2011-15, (£ Million)
- Company strategy
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MiHomecare
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- Figure 106: Financial Analysis of MiHomecare, 2012-2016, (£ 000)
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- Figure 107: Financial Analysis of Complete Care Holdings, 2011-2015, (£ 000)
- Company strategy
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Newcross Healthcare Solutions
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- Figure 108: Financial Analysis of Newcross Health Solutions, 2011-2015, (£ 000)
- Company strategy
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Sevacare
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- Figure 109: Financial Analysis of Sevacare , 2011-2015, (£ 000)
- Company strategy
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- Figure 110: Profiled Companies’ Combined Turnover, 2011-2015, (£ Million)
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Forecast
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- Key points
- Market size
- Demographic trends suggest strong demand and higher number of fully dependent care users
- Residential care market trends also affect the development of the domiciliary care market
- Market size forecast
- Sluggish growth expected in the market over the next five years
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- Figure 111: Forecast UK Domiciliary Care Market Value, 2016/17-2020/21, (£ Million at 2016 prices)
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- Figure 112: Forecast UK Domiciliary Care Market Value, 2016/17-2020/21, (£ Million at 2016 prices)
- Commercial market size forecast
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- Figure 113: Forecast UK Commercial Domiciliary Care Market Value, 2016/17-2020/21, (£ Million at 2016 prices)
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- Figure 114: Forecast UK Commercial Domiciliary Care Market Value, 2016/17-2020/21, (£ Million at 2016 prices)
- Market segmentation
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- Figure 115: Forecast UK Domiciliary Care Market Segmentation Value, by Type, 2016/17-2020/21, (£ Million at 2016 prices)
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- Figure 116: Forecast UK Domiciliary Care Market Segmentation Value, by Type, 2016/17-2020/21, (£ Million at 2016 prices)
- Service fee pressures force providers to consider market position
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- Figure 117: Average Hourly Price Paid for Domiciliary Care Services, by Region, 2015, (£ per Hour)
- Figure 118: Average Hourly Price Paid for Domiciliary Care Services, by Region, 2015, (£ per Hour)
- The ‘subsidy’ effect provided by the self-funding market may be on the decline
- Increasing the use of care technology could help expand service provision and make more efficient use of current funding levels
Further Sources and Contacts
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- Trade associations & organisations
- Trade magazines
- Trade exhibitions
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