Implementing Self-Directed Support
Author: Simon Duffy
It is still too early to evaluate the successes and failures of the English implementation of self-directed support (SDS). Much has been achieved; but many hopes also seem dimmer. This short paper offers some thoughts about the lessons that other countries might want to draw from the English experience.
In summary, despite some succcess, central government in England has so far failed to:
- Use SDS to enhance citizenship
- Support local leadership and community development
- Enable efficient implementation
- Integrate or simplify the management of resources
These mistakes are not necessary and they probably reflect the particularly centralised and meritocratic nature of the welfare system in England. Hopefully other countries will choose to a different path. The recent commitment in Australia to create a proper system of entitlements in order to underpin self-directed support is particularly encouraging.
1. FOCUS ON CITIZENSHIP
Self-directed support was first developed in Scotland and the North of England as a way to enhance social justice, independent living and the citizenship of disabled people. However focus on these objectives has become weaker over time. Central government in England has taken a more technocratic approach, influenced by the dominance of market-thinking in Whitehall.
To avoid this it would be useful for leaders in other countries to reassert the value of:
- The rights and responsibilities at the heart of SDS, clarifying entitlements and citizen’s responsibilities.
- The need for maximal flexibility of resources and for different management options, not limited to the use of direct payments.
- Citizenship outcomes, moving from process monitoring towards a focus on independent living and active citizenship.
Many people find that they are nominally included within a system of SDS, but that they then lack meaningful control. The system still treats people as service users, not as citizens.
2. FOCUS ON LOCAL COMMUNITIES
SDS was developed in a partnership between local government and disabled people. At its best it offers a way in which the role of local government can be developed to support local citizenship and local communities. Unfortunately, as the leadership of SDS has slipped from the local to the central, there has been a tendency, in some localities, for local government to shift into the role of ‘policy-servant’ to Whitehall. Policies and procedures have been implemented from above, despite the fact that central government often has a poor grasp over good practice.
It would make more sense to support local leaders to manage the process of change:
- Treat SDS as an innovation in its early stages, not as a fully developed system - rushing to implement poorly designed system-changes will, in the long-run, damage trust and increase frustration with current systems.
- Encourage local networking and the development of agreed standards and processes. Diverse implementation patterns combined with the open sharing of experiences will create a better culture for sustained innovation.
Local communities do not see the connection between SDS and their own local goals. Centrally imposed targets have bred cynicism and poor quality implementation. Effective implementation requires a combination of local leadership, with communities crafting their own solutions, together with a clear national and legal framework of entitlements.
3. FOCUS ON MEANINGFUL IMPLEMENTATION
The central implementation challenge, after the early enthusiasm died down, was to make the reformed system normal: efficient, easy to use and universal. This cannot be achieved by simply reasserting the policy goal or by setting targets. Meaningful and effective implementation requires older systems to be removed and new systems to be put in their place. In England this process has not taken place and SDS has become another sedimentary layer - added on top of the older systems.
To avoid this mistake there must be much greater focus on good implementation:
- Reduce burdens on front-line workers and disabled people, reduce bureaucracy and increase transparency.
- Do not allow new approaches to ossify or become unduly complex (e.g. RAS, support planning, brokerage etc.)
- Ensure legal structures are permissive and reinforce well established good-practice.
- Pay more attention to the lived experience of disabled people using SDS as the true test of effective implementation.
SDS was developed to make independent living easier. Redesigning all the necessary systems to make this a reality requires cooperation between disabled people, local and central government and other community organisations (including service providers).
4. FOCUS ON INTEGRATION
Central policy confusion has led to an array of confusing terms and competing concepts (self-directed support, personalisation, personal budgets and individual budgets et al.). Partly this confusion reflects competing views within central government and partly central government’s desire to assert their control over this agenda. This has resulted in considerable policy confusion. In England there are now multiple pilots of individual and personal budgets (children, education, DWP and health).
Other countries may want to avoid this confusion by:
- Letting local government take a lead developing genuinely integrated approaches that draw resources out of different silos and into one individual budget.
- Showing greater strategic leadership and understanding of the need to overcome the inevitable resistance that arises from within those silos.
The integration of distinct funding streams within an individual budget is feasible, but it needs to be developed organically and with clear leadership assigned to local government.
SDS works. This is why local leaders, disabled people and service providers can work with it in order to bring about positive change, even when national policy is unhelpful. However, it would be exciting to see central government show the necessary leadership and strategic vision to ensure that SDS did not just work, but worked well. It is to be hoped that other countries around the world build upon what has worked within the English experience, but it is also to be hoped that there is no repeat of the same mistakes.
The publisher is The Centre for Welfare Reform.
Implementing Self-Directed Support © Simon Duffy 2011.
All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.