Evaluating the outsourcing of social care in England
At the Government Outcomes Lab, we are investigating the complex realities of outsourcing in adult and children’s social care, challenging assumptions that market-driven solutions can resolve critical issues of service provision and quality.
Led by Dr Anders Bach-Mortensen, Dr Eleanor Carter, and Dr Benjamin Goodair, Dr François Schoenberger and Bella Kelly this project works to deepen understanding of how outsourcing shapes care quality and access. Through a mixed-methods approach, we analyse local authority outsourcing trends, examine how contractual terms align with service outcomes, and engage directly with practitioners through expert interviews and co-creation workshops.
Research findings:
- Outsourcing has exacerbated care inequalities: in adult social care system as the best quality for-profit providers cater to wealthier self-funding residents, while the worst serve state-funded residents.
- Outsourcing has worsened care sufficiency: in the children social care system as commercial children’s home companies locate in areas they aren’t needed – driving the market away from high-need areas.
- Outsourcing of social care has attracted offshore and private equity interest: a quarter of children’s homes in England can be linked to investment firms in their ownership structure.
Ongoing work:
We are currently working on three major projects
- What are the experiences of social care outsourcing?
We are interviewing commissioners, providers, and social workers to understand their experiences of working with the market for children’s homes. - What is the impact of company takeovers on care?
We are analysing the transition in ownership of care providers. - How are inequalities produced by outsourced markets?
We are exploring the mechanisms through which inequalities are produced in social care markets.
By generating robust, experience-informed evidence, this project will equip policymakers, commissioners, and service providers with the insights needed to improve social care delivery. Ultimately, we seek to answer pressing questions about the role of the private sector in delivering essential social services and ensure that outsourcing decisions are driven by a commitment to high-quality, equitable care.
You can read more about the research here.
The GO Lab team
Anders Bach-Mortensen
Senior Postdoctoral Researcher
Eleanor Carter
Academic Director
Ben Goodair
Senior Postdoctoral Researcher
François Schoenberger
Postdoctoral Researcher
Publications
Bach-Mortensen, A., Goodair, B., Degli Esposti, M., & Needham, C. (2025). England’s two-tier care system deepens social care inequalities. BMJ, 390. doi: https://doi.org/10.1136/bmj-2025-084808
Bach-Mortensen, A., Goodair, B., & Degli Esposti, M. (2025). Resident funding and care home quality: A retrospective observational analysis of the impact of the two-tier care system in england. Age and Aging, Volume 54, Issue 5. doi: https://doi.org/10.1093/ageing/afaf100
Goodair, B., McManus, A., Degli Esposti, M., & Bach-Mortensen, A. M. (2024). How outsourcing has contributed to england’s social care crisis. BMJ, 387, e080380. doi: https://doi.org/10.1136/bmj-2024-080380
Bach-Mortensen, A., Goodair, B., Helby Peterson, O., & Kvist, J. (forthcoming). Market failure in a universal welfare state? ownership, quality, and regulation in danish social services. Social Science and Medicine
Goodair, B., Schoenberger, F., & Bach-Mortensen, A. (forthcoming). Commercialisation and care sufficiency: An observational study of children’s social care privatisation in england from 2014 to 2023. The Lancet Public Health