Under the Social Services and Well-being (Wales) Act 2014, local health boards and local authorities are required to work together to maximise their influence to shape the future development of care accommodation services. This includes ensuring there is sufficient capacity and an appropriate range of good quality services to respond to the needs of people in their region.


This joint approach will encompass both local authority placements and NHS funded placements (funded nursing care and continuing NHS healthcare). It may also encompass short term interim placements to facilitate transfers of care from hospital and choice of accommodation, intermediate care beds (step up/step down), long term placements, respite care and other services that partners wish to commission from care homes. In developing their integrated approach to commissioning, the partners will need to take account of the needs of people funding their own care.


The requirement for pooled funds in relation to the care home accommodation functions will come into force in April 2018. As part of this process, local health boards and local authorities will be expected to:


  • Undertake a population needs assessment and market analysis to include the needs of self-funders.
  • Agree an appropriate integrated market position statement and commissioning strategy. These will specify the outcomes required of care homes, including the range of services required. There should also be an agreement on the methods of commissioning (for example, some services may require a block contract, step up, step down intermediate care services, respite care, etc).
  • Agree a common contract and specification.
  • Develop an integrated approach to agreeing fees with providers.
  • Develop an integrated approach to quality assurance.
  • Adopt a transparent use of resources. Budgets must be aligned with overall expenditure identified, together with the financial commitments of both agencies to the commissioning of care homes. These arrangements will need to be subject to a written agreement.


To read more about the work we are undertaking on joint commissioning for older people services, please click here.