Home Care & Commissioning
Care at Home Is Growing, and So Is the Complexity of Buying It
LaingBuisson values UK homecare and supported living at over £15bn a year, serving an estimated 915,000 adults in England. The same research concludes that growth is set to slow over the coming decade, with funding constraints and limited productivity gains, and that it is the most fragmented market in UK health and social care, with the four largest operators holding just 8.1% of addressable market value, according to LaingBuisson. An ageing population and a strong preference for care at home are likely to keep demand rising, even as growth moderates.
What our briefings cover
Domiciliary and Live-In Care. Visiting care, reablement, live-in and respite care, and extra care housing.
Supported Living and Complex Care. Supported living for adults with learning disabilities or autism, NHS Continuing Healthcare (CHC), Section 117 aftercare, complex and palliative care at home, and residential and nursing placements. These have different responsibilities and funding rules, and briefings keep them distinct.
Community Equipment and Technology. Equipment loan services, telecare, assistive technology and home adaptations.
Commissioning Models. Section 75 pooled budgets, Dynamic Purchasing Systems (DPS), the Provider Selection Regime (PSR), Integrated Care Boards (ICBs), and voluntary and community partnerships.
The commercial reality: capacity, price and continuity move together
Block contracts, frameworks and spot purchasing each secure care differently, and the useful question is when each secures suitable care at a sustainable cost. Cost-of-care exercises, provider continuity and delayed discharge are linked. Joint funding between councils and the NHS depends on shared assessment criteria and agreed splits. Moving someone's care package is a clinical and personal event, so the cost of change is high.
Our briefings follow how this market is changing hands and changing shape, in the most fragmented corner of UK health and social care. In April 2026 Sovereign-backed Eden Futures acquired Complesso, a West Midlands provider with nearly 500 staff, according to Sovereign Capital. We look at investor appetite for care providers, the mix of private, not-for-profit and franchised models, regulation including the Provider Selection Regime and registration standards, and how frameworks, consortia and ICBs shape purchasing and where outcome-linked payment fits.
Last updated by Ajay Channana for Ipso Facto on 16 October 2026