Table of Contents
Executive Summary
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- Market size
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- Figure 1: UK market for domiciliary care, 2012/13-2016/17, (£ million)
- Figure 2: Segmentation of the UK market domiciliary care, by type of purchaser, 2012/13-2016/17, (£ million)
- Market trends
- ‘Old age support ratio’ anticipated to continue to decline despite planned changes to pension age
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- Figure 3: UK population projections, by age group, 2017-41, (million people)
- The gap between costs and fees continue to burden delivery of care services
- Turnover rate declines on 2016 as market adapts to higher minimum wage
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- Figure 4: Annual workforce turnover rates in the independent and voluntary domiciliary care sector, England, 2015-17, by employee position, (%)
- Agencies that provide care to largest groups most likely to require improvement
- The consumer
- Nearly seven in 10 people have not thought about how they would pay for care
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- Figure 5: Domiciliary care payment plans, June 2017, (% of respondents)
- Personal savings and pension income expected to fund long-term care
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- Figure 6: Domiciliary care payment method, June 2017, (% of respondents)
- Nearly a third would prefer a family member or friend to provide them with care over an agency
- Help with daily routines and use of complementary tech would be in-demand for inclusion in home care services
- Rising costs represent largest concern
- Companies
- Growing care intensive needs and higher costs affecting M&A activity
- Number of providers withdrawing from contracts occurring at higher rate
- Lifeways Group is the current market-leader
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- Figure 7: Independent sector domiciliary providers’ market share, 2017, (% of total independent sector market)
- Forecast
- Weak growth expected in the market to 2021/22
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- Figure 8: Forecast UK domiciliary care market value, 2017/18-2021/22, (£ million at 2017 prices)
- Value of informal care expected to remain significant over the coming years
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- Figure 9: Forecast UK domiciliary care market segmentation value, by type, 2017/18-2021/22, (£ million at 2017)
- What we think
Key Insights
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- Is growth in informal care sustainable over the long term?
- Can innovative ideas help change and improve home care provision to meet rising demand?
- What does the future hold for the industry?
Introduction
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- Definitions
- Methodology
- Abbreviations
- Market positioning
UK Economy
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- Key points
- Overview
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- Figure 10: UK GDP, 2005-15, (% quarterly growth and GDP in £ billion)
- Figure 11: UK output, by industry, 2008-16, (index 2012 = 100)
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- Figure 12: Quarters after GDP peak, 1979, 1990 and 2008, (number of quarters and GDP as % of pre-downturn peak)
- Inflation
- Interest rates
- House prices
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- Figure 13: UK house price changes, 2004-16, (12-month % change)
- Consumer spending
- Manufacturing
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- Figure 14: UK manufacturing, 2013-16, (Index, 2012 = 100)
- Business investment
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- Figure 15: UK GFCF 2003-15, (£ million)
- Imports
- Exports
Market Factors
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- Key points
- Increase in the number of elderly people and changes to the pension system will affect how the current system operates
- Rising staff costs due to NLW and NMW rate implementation putting service provision under pressure...
- ...with councils offering little funding relief to providers by offering them low fee rates
- Increasing number of home care scandals and complaints regarding service quality show the current strain on provision
- Announcements following the start of Brexit negotiations have not eased concerns regarding potential staff shortages
- 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 16: UK market for domiciliary care, 2012/13-2016/17, (£ million)
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- Figure 17: UK market for domiciliary care, 2012/13-2016/17, (£ million)
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- Figure 18: UK commercial market for domiciliary care, 2012/13-2016/17, (£ million)
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- Figure 19: UK commercial market for domiciliary care, 2012/13-2016/17, (£ million)
Market Segmentation
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- Key points
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- Figure 20: Segmentation of the UK domiciliary care market, by type of purchaser, 2012/13-2016/17, (£ million)
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- Figure 21: Segmentation of the UK domiciliary care market, by type of purchaser, 2012/13-2016/17, (£ million)
Local Authority Expenditure
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- Key points
- Local authority expenditure
- Older people (65+)
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- Figure 22: Segmentation of local authority expenditure on domiciliary care for older people (65+) in the UK, by type, 2011/12-2015/16, (£ million)
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- Figure 23: Segmentation of local authority expenditure on domiciliary care for older people (65+) in the UK, by type, 2011/12-2015/16, (£ million)
- Adults aged 18-64
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- Figure 24: Segmentation of local authority expenditure on domiciliary care for adults aged 18-64 in the UK, by client type, 2011/12-2015/16, (£ million)
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- Figure 25: Segmentation of local authority expenditure on domiciliary care for adults aged 18-64 in the UK, by client type, 2011/12-2015/16, (£ million)
- Figure 26: Segmentation of UK local authority expenditure on domiciliary care, all adults, by client type, 2011/12-2015/16, (%)
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- Figure 27: Segmentation of UK local authority expenditure on domiciliary care, all adults, by client type, 2011/12 and 2015/16, (%)
- Number of contact hours
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- Figure 28: Number of contact hours of home care provided in the UK, by sector and country, 2012/13-2016/17, (million hours)
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- Figure 29: Number of contact hours of home care provided in the UK, by sector, 2012/13-2016/17, (million hours)
- Regional LA Expenditure
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- Figure 30: Local authority expenditure, all adults, by region, 2011/12-2015/16, (£ million)
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- Figure 31: Local authority domiciliary care expenditure for all adults, by age category, 2011/12-2015/16, (£ million)
- Figure 32: Local authority expenditure, older people (65+), by region, 2011/12-2015/16, (£ million)
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- Figure 33: Local authority expenditure, older people (65+), by region, 2011/12 and 2015/16, (£ million)
- Figure 34: Local authority expenditure, adults (18-64) with physical or sensory disabilities, by region, 2011/12-2015/16, (£ million)
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- Figure 35: Local authority expenditure, adults (18-64) with learning disabilities, by region, 2011/12-2015/16, (£ million)
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- Figure 36: Local authority expenditure, adults (18-64) with mental health needs, by region, 2011/12-2015/16, (£ million)
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- Figure 37: Local authority expenditure, all adults (18-64), by region, 2011/12-2015/16, (£ million)
- Additional government funding allocated to adult social care unlikely to fill the funding gap
NHS Expenditure
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- Key points
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- Figure 38: Segmentation of NHS Expenditure on social care community services, by country, 2012/13-2016/17, (£ million)
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- Figure 39: Segmentation of NHS expenditure on social care community services, by country, 2012/13 and 2016/17, (% 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 40: Segmentation of private expenditure on domiciliary care in the UK, by type, 2012/13-2016/17, (£ million)
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- Figure 41: Segmentation of private expenditure on domiciliary care in the UK, by type, 2012/13-2016/17, (£ million)
- Figure 42: 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 43: 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 44: Informal carers by relationship to person receiving care in England, 2011/12-2015/2016, (% of informal carers)
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- Figure 45: The UK market for informal domiciliary care, 2012/13-2016/17, (£ billion and hours)
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- Figure 46: UK market for informal domiciliary care, 2012/13-2016/17, (£ billion and billion hours)
Market Trends
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- Key points
- Old age support ratio anticipated to continue to decline despite planned changes to pension age
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- Figure 47: UK population projections, by age group, 2017-41, (000 people)
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- Figure 48: Estimated and projected age structure of the United Kingdom population, by sex, mid-2017 and mid-2041, (thousands)
- The gap between costs and fees continue to burden delivery of care services
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- Figure 49: Estimated minimum price for home care, 2016, (£)
- Turnover rate declines as market adapts to higher minimum wage
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- Figure 50: Annual workforce turnover rates in the independent and voluntary domiciliary care sector, England, 2015-17, by employee position, (%)
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- Figure 51: Annual workforce turnover rates in the independent and voluntary domiciliary care sector, England, 2015-17, by employee position, (%)
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- Figure 52: Average annual pay in the independent and voluntary domiciliary care sector, England, 2015-17, by employee position, (£)
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- Figure 53: Average annual pay in the independent and voluntary domiciliary care sector, England, 2015-17, by employee position, (£)
- Agencies that provide care to largest groups most likely to require improvement
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- Figure 54: CQC inspection outcomes, England, May 2017, (service size, rating and number of registered locations inspected)
- Funding deficit has placed a greater strain on NHS resources with growing delays in hospital discharge
Regional Analysis
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- Key points
- England
- North East
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- Figure 55: Analysis of local authority domiciliary care expenditure on older people in the North East of England, by authority, 2011/12-2015/16, (£000)
- North West
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- Figure 56: Analysis of local authority domiciliary care expenditure on older people in the North West of England, by authority, 2011/12-2015/16, (£ 000)
- Yorkshire & the Humber
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- Figure 57: Analysis of Local authority domiciliary care expenditure on older people in Yorkshire & The Humber, by authority, 2011/12-2015/16, (£000)
- East Midlands
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- Figure 58: Analysis of local authority domiciliary care expenditure on older people in the East Midlands by authority, 2011/12-2015/16, (£000)
- West Midlands
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- Figure 59: Analysis of local authority domiciliary care expenditure on older people in the West Midlands, by authority, 2011/12-2015/16, (£000)
- South West
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- Figure 60: Analysis of local authority domiciliary care expenditure on older people in South West England, by authority, 2011/12-2015/16, (£000)
- East of England
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- Figure 61: Analysis of local authority domiciliary care expenditure on older people in East of England, by authority, 2011/12-2015/16, (£000)
- London
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- Figure 62: Analysis of Local Authority domiciliary care expenditure on older people in London, by authority, 2011/12-2015/16, (£000)
- South East
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- Figure 63: Analysis of local authority domiciliary care expenditure on older people in the South East of England, by authority, 2011/12-2015/16, (£000)
- Scotland
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- Figure 64: Domiciliary care clients in Scotland, by client type and authority, 2016/17, (number of clients)
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- Figure 65: Distribution of home care hours per week in Scotland, 2016/17, by time band and district, (% of clients)
- Wales
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- Figure 66: Number of domiciliary care clients aged 65+ in Wales, 2011/12-2015/16, by local authority, (number of clients)
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- Figure 67: Number of domiciliary care clients aged 18-64 in Wales, 2011/12-2015/16, by local authority, (number of clients)
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- Figure 68: Local authority domiciliary care expenditure in Wales, by local authority, 2011/12-2015/16, (£000)
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- Figure 69: Hours of home care provided in Wales, by local authority, 2011/12-2015/16, (000 hours)
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- Figure 70: Percentage of home care hours contracted to the independent sector, by local authority, 2011/12-2015/16, (% of home care hours)
- Northern Ireland
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- Figure 71: Number of clients receiving domiciliary care in Northern Ireland, by sector and HSC Trust, 2015/16, (number of clients during survey week)
- Figure 72: Number of clients receiving domiciliary care in Northern Ireland, by sector and HSC Trust, 2016/17, (number of clients during survey week)
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- Figure 73: Number of home care hours provided per week, by sector and HSC Trust, 2015/16, (number of hours provided during survey week)
- Figure 74: Number of home care hours provided per week, by sector and HSC Trust, 2016/17, (number of hours provided during survey week)
The Consumer - Care Payment
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- Key points
- Nearly seven in 10 people have not thought about how they would pay for care
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- Figure 75: Domiciliary care payment plans, June 2017, (% of respondents)
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- Figure 76: Domiciliary care payment plans, June 2017, (% of respondents)
- Half of over-65s have considered the financial consequences of care
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- Figure 77: Domiciliary care payment plans, by age and gender, June 2017, (% of respondents)
- Personal savings and pension income expected to fund long-term care
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- Figure 78: Domiciliary care payment method, June 2017, (% of respondents)
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- Figure 79: Domiciliary care payment method, June 2017, (% of respondents)
The Consumer - Home Care Provider
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- Key points
- Nearly a third would prefer a family member or friend to provide them with care over an agency
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- Figure 80: Domiciliary care provider, June 2017, (% of respondents)
- Lack of care payment plans will drive people towards care from family or friends
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- Figure 81: Domiciliary care provider, by care payment plans, June 2017, (% of respondents)
The Consumer - Care Service Features
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- Key points
- Help with daily routines and use of complementary tech are in-demand home care services
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- Figure 82: Domiciliary care service features, June 2017, (% of respondents)
The Consumer - Future Care Concerns
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- Key points
- Rising costs represent largest concern...
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- Figure 83: Future domiciliary care concerns, June 2017, (% of respondents)
- ...with this concern growing with age
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- Figure 84: Future domiciliary care concerns, by age and gender, June 2017, (% of respondents)
Industry Structure
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- Key points
- Industry development
- Growing care intensity and higher costs affecting M&A activity
- Increasing number of providers withdraw from local authority contracts
- Emergence of new online platforms
- Lifeways Group is the current market-leader
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- Figure 85: Independent sector domiciliary care providers’ market share, 2017, (% of total independent sector market)
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- Figure 86: Independent sector domiciliary providers’ market share, 2017, (% of total independent sector market)
- More businesses operating from a lower number of local units on average
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- Figure 87: Analysis of the changes in the structure of the ‘other human health activities’ industry, 2012-16, (number of local units and businesses)
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- Figure 88: Analysis of the changes in the structure of the ‘social work activities without accommodation for the elderly and disabled’ industry, 2012-16, (number of local units and businesses)
- Structure by employment
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- Figure 89: Analysis of the employment structure of the ‘other human health activities’ industry, 2015 and 2016, (number of local units and local unit employment size)
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- Figure 90: Analysis of the employment structure of the ‘social work activities without accommodation for the elderly and disabled’ industry, 2015 and 2016, (number of local units and local unit employment size)
- Structure by turnover
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- Figure 91: Analysis of the financial structure of the ‘other human health activities’ industry, 2015 and 2016, (£ 000 and % of total turnover)
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- Figure 92: Analysis of the financial structure of the ‘social work activities without accommodation for the elderly and disabled’ industry, 2015 and 2016, (£ 000 and % of total turnover)
Company Profiles
Allied Healthcare (now part of Aurelius Group)
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- Figure 93: Financial analysis of Allied Healthcare Group, 2012-16, (£ million)
- Company strategy
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Ark Home Healthcare
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- Figure 94: Financial analysis of Ark Home Healthcare, 2012-16, (£ 000)
- Company strategy
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Chrysalis Community Care
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- Figure 95: Financial analysis of Chrysalis Community Care Group, 2011-16, (£ 000)
- Company strategy
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Interserve Healthcare (formerly Advantage Healthcare)
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- Figure 96: Financial analysis of Interserve, 2011-15, (£ 000)
- Company strategy
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Lloyds Pharmacy Clinical Homecare (formerly Bupa Home Healthcare)
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- Figure 97: Financial analysis of Lloyds Pharmacy Clinical Homecare (formerly BUPA Home Healthcare), 2011-15, (£ million)
- Company strategy
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Mears Group
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- Figure 98: Financial analysis of Mears Group, 2012-16, (£ million)
- Company strategy
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MiHomecare
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- Figure 99: Financial analysis of MiHomecare, 2012-16, (£ 000)
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- Figure 100: Financial analysis of Complete Care Holdings, 2012-16, (£ 000)
- Company strategy
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Newcross Healthcare Solutions
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- Figure 101: Financial analysis of Newcross Health Solutions, 2012-16, (£ 000)
- Company strategy
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Sevacare
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- Figure 102: Financial analysis of Sevacare, 2012-16, (£ million)
- Company strategy
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- Figure 103: Profiled companies’ combined turnover, 2012-16, (£ 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
- Market size forecast
- Weak growth expected in the market to 2021/22
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- Figure 104: Forecast UK domiciliary care market value, 2017/18-2021/22, (£ million at 2017 prices)
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- Figure 105: Forecast UK domiciliary care market value, 2017/18-2021/22, (£ million at 2017 prices)
- Commercial market size forecast
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- Figure 106: Forecast UK commercial domiciliary care market value, 2017/18-2021/22, (£ million at 2017 prices)
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- Figure 107: Forecast UK commercial domiciliary care market value, 2017/18-2021/22, (£ million at 2017 prices)
- Market segmentation
- Conservative’s social care election manifesto pledge, albeit scrapped after the election result, could serve as an indication of how changes will be made to social care funding
- Value of informal care expected to remain significant over the coming years
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- Figure 108: Forecast UK domiciliary care market segmentation value, by type, 2017/18-2021/22, (£ million at 2017 prices)
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- Figure 109: Forecast UK domiciliary care market segmentation value, by type, 2017/18-2021/22, (£ million at 2017 prices)
- The introduction and rise in NLW since 2016 has led to UK-wide variation in hourly price...
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- Figure 110: Average hourly price paid for domiciliary care services, by region, April 2016, (£ per hour)
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- Figure 111: Average hourly price paid for domiciliary care services, by region, April 2016, (£ per hour)
- ...with Brexit likely to add to staffing pressures which could further increase fees
- New operating models could answer reducing service demand pressures
Further Sources and Contacts
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- Trade associations & organisations
- Age UK
- Care England (formerly English Community Care Association)
- Carers UK
- National Care Association
- National Care Forum
- Social Care Association
- United Kingdom Home Care Association
- Trade magazines
- Care Management Matters
- Care Talk
- Caring Times
- Caring UK
- Community Care
- Trade exhibitions
- Care England 2017
- Care Show 2017
- Care Roadshow London 2017
- Community Care Live 2017
- Health + Care 2018
- Primary Care and Public Health 2018
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