The home medical assistance market - United Kingdom

As the population ages, the demand for health care will increase. The Office of National Statistics projects a 36% growth in the number of people at age 85 and older between 2015 and 2025, from 1.5 million to 2 million. This is expected to result in a substantial increase in demand for home health care services. The care home sector, was worth approximately £16.6 billion per year in the UK in 2019. As a reminder, home care is supportive care provided in the home by licensed healthcare professionals. Thus, activities by professional caregivers helping with activities of daily living will be excluded from our study. Indeed, services such as help with shopping, ironing or cleaning are not medical services but only services provided to medically unfit people. A large part of the market regards services to the elderly, but home health care is also provided to people with long-term illnesses and disabilities, as well as to those who have recently been discharged from hospital. Home care can be provided and funded by a variety of people or organizations. Local authorities (LAs) play a major role in the home health care market by purchasing home care services for some of its residents. This includes direct purchase from service providers, volunteer services, and private service providers. Under the Care Act 2014, local authorities have a statutory duty to "shape" this market, to ensure that there are enough services of sufficiently high quality to meet need. Private clients who, for example, are not eligible for LA home care can also purchase home care directly from private service providers. For the NHS, it is essential to allow people to "age in place" and to provide care as close to home as possible. However, due to budget cuts, local authorities are struggling to fund these services for an aging population, and the shortage of care is only compounding the NHS's difficulties. Moreover, between 2017 and 2018, three of the nation's largest home care providers (Saga, Care UK, and Housing 21) exited the publicly funded home care market, while two others (Mears and Mitie) reported losses in their home care divisions. Thus, the health care market appears uncertain and fragile; the greatest challenges remain for public services to be able to provide quality home care while seeking greater efficiency. Industry innovations such as telemedicine, telehealth, and remote telecare are responses to this challenge.