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BACKGROUND: The responsibility of local authorities in England to provide children in care with stable, local placements has become increasingly difficult due to the rising number of children in need of care and a shortage of available placements. It is unclear if the trend of outsourcing children's social care to private companies has exacerbated this challenge. This paper examines how the outsourcing of children's social care to the private market has influenced placement locality and long-term stability over time. METHODS: We created a novel dataset of multiple administrative data sources on the outsourcing, placement locality and stability, and characteristics of children in care between 2011 and 2022. We conducted time-series fixed-effects regression analysis of the impact of for-profit outsourcing on placement locality and stability from 2011 to 2022. RESULTS: Our fully adjusted models demonstrate that for-profit outsourcing is consistently associated with more children being placed outside their home local authority and greater placement instability. We found that an increase of 1 % point of for-profit outsourcing was associated with an average increase of 0.10 % points (95 % CI 0.02-0.17; p = 0.01) more children experiencing placement disruption, and 0.23 % points (95 % CI 0.15-0.30; p < 0.001) more children being placed outside their home local authority. We estimate that an additional 17,001 (95 % CI 9015-24,987) out-of-area placements can be attributed to increases in for-profit provision. DISCUSSION: Our analyses show that placement stability and distance have deteriorated or stagnated over the last decade, and that the local authorities that rely most on outsourcing have the highest rates of placement disruptions and out-of-area placements.
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