How Strategic Partnerships Can Support the Growth of Private Social Care

Start by redefining the market you’re in

A central theme of the discussion was the need to move beyond a vague, monolithic understanding of social care. The roundtable paused on a deceptively simple question: what do we actually mean by social care?

The consensus was clear. Social care is not a single market, it spans multiple, distinct cohorts with very different needs. These include end‑of‑life care; dementia and dementia‑plus groups; learning disability and autism; brain injury; supported living for younger adults; time‑limited intermediate care for discharge and more. Treating all these diverse needs as a single “care home market” leads to generic provision that struggles to differentiate or integrate. Growth becomes reactive rather than strategic.

Providers that succeed tend to define themselves not by asset type such as “a care home” but by the specific problems they solve. That might be stabilising people with dementia-plus behaviours or supporting individuals who do not meet hospital criteria but cannot live independently. This clarity matters because it determines everything else: who your partners are, how your service is commissioned, what workforce you need and what kind of building will actually support your model.

From Silos to Ecosystems

The NHS has made its long-term direction clear: care should move away from hospitals and into community settings wherever possible. Yet, as several contributors noted, care cannot simply be “left-shifted” without consideration of where it’s going to go, it must land somewhere and that “somewhere” is often private social care. The opportunity for providers is to stop seeing themselves as the end point of a pathway and start seeing themselves as part of a wider system. That means designing services that actively solve system problems rather than passively absorbing demand.

This shift requires a change in mindset. Instead of asking, “How do we fill beds?”, the more useful question becomes, “What pressure are we relieving and for whom?”. When providers can answer that clearly, partnership conversations become much easier, because they are grounded in shared problems rather than abstract capacity.

Designing pathways that actually work

The gap between policy intent and practice is most visible in discharge. “Discharge to assess” (D2A) should, in theory, enable better outcomes by assessing people at home or in a non-acute setting. As Livadeas argued,

It often fails because it’s treated as a passive discharge route with little follow-up and there’s very little research to support it.

One example discussed at the roundtable flipped that logic. A Gloucestershire model concentrated D2A beds across a small number of homes, co-located occupational therapy and physiotherapy resource and started rehabilitation from day one. Focus, consistency and daily therapy turned a pathway into a genuine intervention rather than a holding space. The lesson here is simple but important: partnerships work when pathways are deliberately designed and resourced, not loosely connected. Williams reinforced this point, highlighting how inconsistency between NHS bodies, local authorities, providers and regions makes it difficult to define pathways, measure outcomes or replicate success.  The cost of that fragmentation is felt the most by individuals who end up stuck in hospital beds or sent far from home.

For providers thinking about growth, the most practical starting point is to ask, whose problem do we solve on a Friday at 5pm? Commissioners remember the organisations that step in when hospitals are under pressure, discharge targets are looming, or out-of-area placements are draining budgets and family trust. Turning up consistently in those moments is how credibility is built. As the panel agreed, the goal is to be the solution, not another problem to manage.

Trust, focus and the reality of commissioning

Credibility has to be built in both directions. The panel described how suspicion and misunderstanding persist between local authorities and providers. Commissioners fearing that providers are driven purely by profit and providers feeling commissioners don’t understand basic business drivers like cashflow, risk or the constraints of a newbuild pipeline.

Livadeas described how a difficult relationship shifted when the starting point changed. Instead of leading with negotiation, she led with service: tell us where the pressure points are and we’ll help solve them. Once trust developed, it became possible to have more honest conversations about the true cost of care and what sustainability really looks like.

Trust also scales across the independent sector. Ni Ghadhra described forming a local provider forum so commissioners could see a coherent pathway rather than a collection of competing services. That collaboration made it easier to move people for the right clinical reasons and reduced the “everyone for themselves” dynamic that so often undermines outcomes. It reassured commissioners that providers could work together and helped providers avoid being isolated when pressure increased.

None of this works without focus. Agility is not the same as being all things to all people. The most effective providers pick a segment and design an operating model around it. That means boards signing off on a clear service promise, a staffing model that matches acuity and outcome measures that matter to the local system, such as reduced out-of-area placements, shorter lengths of stay, or fewer readmissions. From there, the estate follows the model, not the other way round. The panel warned against building first and hoping demand will follow. Policy and funding flows change quickly and without a clearly defined problem to anchor the service, even well-intentioned investment can struggle to find its place.