Abstract

Objective: The provision of residential and nursing care has long held a prominent role in English social care sector. This paper measures regional variation in productivity of care homes in England, so as to identify areas in which potential efficiency savings can be made and understand the expected impact (both geographical and organisational) on output of changes to inputs across the country.

Data: We use Personal Social Services Expenditure and Unit Costs and Adult Social Care Survey (ASCS) of 2010 to 2012 to calculate productivity growth for all adult services and older people services, respectively.

Methods: Productivity growth is measured by comparing annual change of the total amount of care home output to annual change of total inputs for each region. Output growth is measured by the percentage volume change in each output and weighting percentage changes by the share of the value of each product in the value of total output using a Laspeyres form. Deflated by Personal Social Services (PSS) Pay and Prices Index, input growth is measured by annual change of expenditure on adult social care by the social services department of Councils with Adult Social Service Responsibilities (CASSRs). We also account for variation in the quality of services across regions using the Adult Social Care Outcomes Toolkit (ASCOT). ASCOT is adjusted at CASSR level using a regression based method.

Results: We find that most regions showed an increasing trend in unadjusted and regression adjusted ASCOT from 2010 to 2011, and a decreasing trend in unadjusted and adjusted ASCOT from 2011 to 2012, for all adult and older adult services. This suggests that quality of services provided in care home may have decreased from 2011 to 2012. Output and input growth were negative from 2010 to 2011 for most regions, and continued to be negative from 2011 to 2012. Similar trends were observed for both all adult and older adult services. In terms of total productivities, some regions showed positive productivity growth from 2010 to 2011, but productivity growth was negative for most regions from 2011 to 2012.

Policy implications: The empirical results of the study suggest that variations in productivity of care homes do exist in different regions. The productivity indices can help the policy makers to monitor the performance of care home in different regions, as well as to understand whether public spending in the social care sector or by its constituent organisations has achieved ‘value for money’. The methods developed in this study can also be used to investigate variations in productivity of other types of social care organisations and social care services.

Acknowledgements: This presentation is based on an independent report commissioned and funded by the Policy Research Programme in the Department of Health from the Economics of Social and Health Care Research Unit (ESHCRU). ESHCRU is a joint collaboration between the University of York, London School of Economics and University of Kent. The views expressed are those of the authors and may not reflect those of the funders.

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