Commissioning intentions and market shaping

Commissioners will be focusing on the following priorities from 2026 to 2028.

Commissioning decisions are informed by Medway’s Joint Strategic Needs Assessment (JSNA).

Further specific profiling for adults who need care and support can be found under the Adult care and support chapter.

We use the Kent Business Portal for our tendering opportunities. 

To be considered for a tender, register for free on the Kent Business Portal.

Medway Care Home and Older People Unit

We’re currently progressing proposals for a new care home and Adult Social Care Units. The site is on land south of the Medway Innovation Centre. This is in response to the rising and significant need for specialist dementia care and insufficient supply across Medway.

Plans for the Innovation Park were put on hold in 2024 because of post-COVID-19 market conditions. In March 2025, we approved alternative development approaches for some of the land, including the southern site. This gives us the opportunity to use a sustainably located site in a way that meets local needs and reduces dependence on independent care providers.

The project design team has been developing proposals that respond to the site's context, opportunities and constraints. They've been informed by technical surveys and assessments, with pre-application engagement with Planning, Highways, and Landscape officers.

The proposals include:

• an 80-bed care home on the northern part of the site comprising:
  • 40 beds on the ground floor for specialist nursing residential dementia care home
  • 40 beds on the first floor for discharge to assess facility
  • a set-back second floor for staff and administration areas
• 11 single-storey Adult Social Care Units on the southern part of the site, designed around a communal landscaped garden and social space for residents
• a comprehensive landscaping proposal to provide greening and softening along the A229 site frontage, supporting biodiversity and ensuring an attractive landscaped setting
• a secure and inclusive environment for care home residents with sensory planting and social areas within courtyard gardens.
• contemporary, energy efficient and sustainable design to respond positively to the site's gateway setting
• staff, resident, and visitor parking alongside a comprehensive Travel Plan to maximise opportunities for sustainable travel to and from the site. A parking Management Plan will be developed, to ensure parking is appropriately managed and that Innovation Centre Medway parking is safeguarded for Innovation Centre Medway use during working hours
• a Sustainable Urban Drainage Scheme.

What happens next

A full planning application was submitted in July 2026.

The Local Planning Authority will undertake statutory consultation prior to determining the application.

If you have any questions, email the Adult Social Care Team adults.commissioning@medway.gov.uk.

Short-term assessment beds

The current short-term assessment beds contract is due to end on 31 March 2027.

In preparation for future commissioning arrangements, we'll undertake market engagement with providers in Autumn 2026 to help inform our commissioning intentions and procurement approach.

Further information on engagement opportunities and future commissioning arrangements will be published soon.

Community activities - day care services

We recognise the importance of day services in preventing, or delaying the need for, more intensive support.

By engaging with community activities people are more likely to continue living the lives they want to. They can do the activities they enjoy with a resilient social network in place where they feel valued, supported and engaged within their local community.

Day care services also provide an essential service for people with more complex care needs who are still able to live at home with support of their families or carers.

Family members and carers often rely on day care services for respite and for the family member or carer to participate in life beyond their caring responsibilities.

We want to develop small and micro-providers in local communities who can provide these valuable activities and will support smaller organisations to develop and become sustainable.

We'll do this by:

• raising awareness of services
• developing a simple payment system which offers users choice whilst ensuring speedy payment for providers
• linking providers with the larger network to enable their service to flourish.

We'll work closely with these organisations so that they:

• receive suitable and appropriate referrals
• are involved in conversations regarding fee structure
• can develop services to meet the needs of existing and future clients.

Residential and nursing services

The current framework contract for residential and nursing care for older persons and working age adults was developed several years ago and there's a need to update the specification, terms and conditions of the contract. The commissioning of good quality nursing and high-frailty dementia nursing care continues to be a top priority, ensuring we meet the complex needs of our most vulnerable population.

We're looking to work with providers that will:

• collaborate with the acute hospital discharge services and all relevant partners, including adult social care, other commissioned services, the voluntary or community sector as required, to enable safe timely transfers of care
• facilitate planned and timely admissions of new residents in the care homes 7 days per week, including the evening
• work within a trusted assessor model, as appropriate
• complete the NHS Capacity Tracker daily to support system flow
• continue to engage with quality officers and commissioners to further improve quality standards
• join new framework agreements for the provision of residential care
• ensure the use of Medway's Integrated Community Equipment Service (MICES) that will deliver good care and timely admissions.

Our intentions are to:

• recommission the care home contracts for older people and working age adults (currently underway) involving widespread consultation with:
  • service users
  • stakeholders
  • providers
• consider increasing the number of block contracts in the sector
• increase overall provision and encourage more providers into the specialist care home market and diversification amongst existing care homes, particularly in:
  • dementia nursing
  • physical disability nursing
  • working age adult mental health
  • working age adult dementia
  • multiple complex needs.

Supported living

We currently commission Supported Living services through a Dynamic Purchasing System (DPS). We're now into the final year of a 4-year contract term, with the DPS due to expire in February 2027.

We're currently reviewing services and considering re-commissioning options.

Provider engagement activities will be held during in the Summer of 2026 and tender opportunities published in Autumn 2026.

We'll publish more information about these activities and opportunities when they are available.

Homecare

The current Support to Live at Home contract started in 2024 and will run until March 2028.

We use KPI monitoring, sustainability and market engagement. We'll improve how we deliver and share the performance data with providers.

We'll continue to focus on supporting and working with providers. This will help us understand the market better, spot common problems or trends, and deal with them early.

We expect to start talking to the market about renewing the Homecare service in the Spring of 2027.

Extra Care

There are 5 Extra Care Housing schemes in Medway. We're reviewing the current policy and guidance so that the information is up to date.

We expect to start talking to the market about renewing the  Extra Care Housing schemes in the Spring of 2027.

Commissioning models

A few long stay residential and nursing placements in Medway are made by spot purchase. Whilst this is largely successful, we face increasing pressures in sourcing certain types of residential care at a sustainable cost.

Whilst the intention is to commission a framework agreement, as part of the commissioning process, we'll consider increasing the number of block contract arrangements with providers where our ability to manage supply and cost is proving difficult.

The block contracts we already have in place are viewed favourably as they:

• provide long term assurance on placement numbers
• support budget management and long term financial planning during this demanding time economically.

Market shaping

Market shaping involves us working with partners and those with lived experience to promote a sustainable, diverse, and high-quality care market, with contingencies for provider failures. This collaborative effort is essential for developing a resilient, diverse and vibrant market. It’s about co-producing outcomes and fostering an environment of honesty and transparency that encourages innovation and cooperation.

Our Market Position Statements provide clarity on the services needed, and our commissioning intentions. This transparency allows providers and suppliers to align their delivery models and business plans with our objectives and values, ensuring a collaborative effort towards enhancing care services.

By stating intentions and setting clear expectations, these statements:

• facilitate a proactive and adaptive approach in the marketplace
• encourage providers to innovate and evolve in response to the outlined needs.

It’s a forward-thinking strategy that fosters a dynamic and responsive care sector, capable of meeting the demands of the community both now and in the future.

Factors influencing the market

The concerning factors faced by Medway’s Adult Social Care services are significant and have many aspects. The challenges and opportunities facing Adult Social Care in Medway are a reflection of the broader trends affecting social care across the UK and globally:

• aging population: with people living longer, there's an increase in complex health needs
• quality and choice: ensuring that people have access to high quality services and a choice in their care
• workforce: retaining and developing a skilled Adult Social Care workforce
• funding: addressing the uncertainty of long term funding for Adult Social Care.

The COVID-19 pandemic has only intensified these challenges, affecting financial stability and service delivery.

However, these challenges are being met with a proactive and collaborative approach. This approach to commissioning is a positive step towards utilising community strengths and resources effectively. By working with partners and the community, there's potential to co-design support systems that are responsive to the needs of our residents, embedding innovation and efficiency into our services.

Our commissioning activity and strategy development is informed by Medway’s JSNA, which contains over 30 topic specific chapters, grouped into the 5 themes of the Joint Health and Wellbeing Strategy, as well as other supporting information, such as an overview of people and place.

The Medway JSNA Executive summary provides a high level overview of the current health and social care needs within Medway.

The emerging JSNA Chapter on Care and Support - Adults with be published in May 2024.

Mitigating opportunities:

• collaborative commissioning: adopting an asset-based approach to commissioning, focusing on community strengths
• innovation: creating an environment where transparency leads to innovation and shared solutions
• co-design: working with residents to co-design support that meets their needs
• flexibility: ensuring services can adapt to changing demands and requirements.

Our focus on flexibility and adaptability in service provision is crucial, especially in times of change. Establishing the right contracting arrangements with suppliers who are ready to adapt will be key to meeting both current and future demands.

We're committed to:

• transparency
• innovation
• shared outcomes.

Despite the challenges, there's a strong resolve to transform and improve Adult Social Care services.