Intermediate Care Service | Provider Hub

Market Context

Intermediate Care is a service provided to adults for a short period of time after leaving hospital or for adults that are at risk at home or in the community and is often used to avoid admission to hospital. This service is jointly supported by Adult Social Care and our NHS partners. This service has a focus on providing care and support for adults either within the home or within a residential setting to maximise a return to levels of autonomy and independence, through the relearning of the personal and domestic activities of daily life.

Essex County Council currently commission five types of services:

Reablement-at-Home Service (RaH): A therapy-supported Intermediate Care service at the adult's home for up to 6 weeks.
Additional Reablement Capacity (ARC): As a therapy-supported reablement service to support the capacity demands of the reablement service, with an identical 6-week limit.
Home-to-Assess Service (H2A): As an opportunity for adults to return home in a non-reablement setting, for up to 2-4 weeks, to allow care assessments to take place once the adult is settled at home.
Recovery-to-Home (RtH): Providing reablement assessment and support within designated residential settings, for up to 6 weeks.
Spot placement of short-term domiciliary care when capacity within the Intermediate Care services (RaH, ARC or H2A) is not available, or a referral has no potential for development in a reablement environment.

There is an additional contracted service to provide therapy support to South-East ARC services.

Essex currently holds numerous contracts with multiple providers to support these services. These are:

Reablement-at-Home Contract: A countywide service for reablement, contracted with Essex Cares Limited (ECL), the wholly owned Local Authority Trading Company of Essex County Council.
Recovery-to-Home Contract: Supported by Essex Cares Limited to address reablement and recovery support, for designated North Essex residential settings.
Additional Reablement Capacity (ARC) Contracts: Five separate contracts with four providers, placed in each of the five service localities across Essex to support demand pressures for out of hospital and to support community referrals.
Home-to-Assess (H2A) Contracts: Five separate contracts with four providers, reflecting the same service localities as ARC, to provide care assessment for 2-4 weeks prior to future care solutions.

Market Rating

The current overall Market Quality is good and past issues with market capacity and workforce no longer exist. Tender activities from 2025 have demonstrated a strong and motivated market, with a clear understanding of reablement services.

Market Quality	Market Supply	ECC Demand
Good	Good	High/Very High

ECC Ambition	Market Workforce	Market Maturity
Manage Supply	Good	Mature/Established

ECC rating of the market, assessed on the 1st April 2026

The reablement service, including both RaH and ARC, has been increasing in provision since September 2022 and is currently contracted to delivering approximately 16,700 hours of reablement care at home each week. Since November 2024, the ECL RaH contract has been measured in weekly ‘finishers’, without a contracted number of hours. These figures (hours and finishers) can be adjusted if required, and increases to the contracted hours have been actioned, based on the availability of additional winter funding.

The current Intermediate Care market is buoyant, as demonstrated by recent tender and market engagement processes, with more than 450 large and SME organisations responding to the 2025 Live-at-Home tender and another 70 expressing interest in the Home-to-Assess procurement.

All past ‘bridging’ services are now complete, as of October 2025.

During 2025, we encountered recruitment issues, but the workforce market is now far more stable with many providers indicating an improved recruitment and retention position, and a reduction in the reliance on the UK Visa Sponsorship programme which had encouraged recruitment from abroad.

Short-term care to maximise independence (reablement services), Essex’s gross expenditure per 100,000 adults is the 4th highest in the CIPFA region for 18 to 64 and 5th highest in the region for 65+ (out of 16 Local Authorities in that region).

Essex ASC Market (ECC Funded)
Spend		£33.6 Million per annum
ECL Capacity (Finishers Per Week)		113
ARC Capacity (Hours per week)		5,250
No. Providers	Reablement-Home	1
	ARC	4
	H2A	4
Good/Outstanding Providers		78%
No. of Spot IC Beds		0
No. Good/Outstanding Spot Providers		N/A

Essex ASC Market - Utilisation
Reablement-at-Home Utilisation	100%
Reablement-at-Home % Self Caring	75.4%
Reablement-at-Home - Average Length of Stay	25.9 Days
Reablement-at-Home - Standard Hourly Rate	Not applicable – Not Hours Based
Additional Reablement Capacity Utilisation	112.1%
Additional Reablement Capacity % Self Caring	65.0%
Additional Reablement Capacity Average Hourly Rate	£25.36
Additional Reablement Capacity - Average Length Stay	31.7 Days
Home-to-Assess Capacity Utilisation	107.1%
Home-to-Assess Average Hourly Rate	£28.08

The information shown in the table(s) above is correct as of 1st April 2026

Our Intermediate Care offer has been subject to a number of transformation processes, including the, now complete, Connect Programme during 2022 to 2024 and the current multi-stage Future of Intermediate Care programme.

The outcomes demonstrate that we are able to speed up the adult flow and place adults on the most appropriate pathway, thereby increasing the number of people using the service and reducing the ongoing needs for the adult into long-term care. H2A also provides a suitable ‘buffer’ to support discharge and reablement in order fully determine service user needs.

The future of Intermediate Care will focus on collaboration with elements of the referral process to pursue common goals and closer working relationships. This route will ensure an improved customer journey and value-for-money for the taxpayers of Essex.

Current information is indicating that past pressure on the Domiciliary market to pick up packages of care for long-term provision is no longer present.
Increased costs, for fuel and daily living, together with repeated increases to the National Living Wage, are putting pressure on wages in the market and the potential for increased costs to be passed to ECC to support market providers.
The legislative changes associated with visa support and the recruitment of workers from overseas have resulted in a reduction in applications, and the release of a number of foreign workers into the market who came to the UK for potential care providers who are no longer able to provide work to these individuals.
The consolidation of the NHS ICBs in Essex into a single organisation has the potential to change funding, relationships and processes across the county.

Second stage of the ‘Future of Intermediate Care’ programme, focused on improved decision-making data and improved relationships between the different elements of the Intermediate Care system.
Informing and developing the Council’s Intermediate Care Dashboard to support service/situational awareness and operational decision making.
Benchmarking system components to ensure optimised utilisation of resources and service quality.
Reducing failed starts, and otherwise lost hours, across all reablement's services
Improve throughput of adults in their reablement journey, reducing length of stay and improvements to challenging and proportionate objectives for users.
Ensuring robust and flexible contract arrangements for the on-going delivery of Reablement, ARC and H2A are established and maintained, provider relationships are managed to maximise returns on investment.

Last updated: 01/04/2026

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