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Can ISFs Save Domiciliary Care?

Author: Martin Walker

The shape of social care services is changing. Council and health commissioners (CCGs) are increasingly squeezing margins and demand for greater control from people who use service means there is no room for inefficiency or poor quality service. Sadly, even good and excellent services are beginning to close because they don’t believe their businesses have a future.

For domiciliary care providers, is this a time of inevitable business closure, or is it a time of opportunity to redefine their service offer?

One way both commissioners and providers can work with each other to redefine the domiciliary care market is through greater use of Individual Service Funds (ISFs).

Every council area in England should have an ISF offer in place, but from the work Think Local Act Personal (TLAP) developed last year to support councils to get an offer in place, it is clear that this is far from the case. This needs to change quickly and TLAP are continuing that work in partnership with the Centre for Welfare Reform this year. In areas where there is an offer in place providers are positive about it.

So what are the benefits?

ISFs give providers freedom to meet the needs of customers flexibly and use their knowledge of localities and communities to meet them more creatively and in ways their customers and families want. It enables providers to have a similar relationship with individuals who cannot or do not want to manage a direct payment to those who do by managing the fund on their behalf.

It is a mechanism by which individuals can choose their provider rather than the local authority.

They offer the opportunity to deliver system and process efficiencies across councils and providers. They can do this by reducing and eliminating layers of bureaucracy.

For staff, they offer the opportunity to work more consistently with customers and deliver the person centred care they often wish to provide but are constrained from doing so by unrealistic time and task specifications.

Importantly, they can stimulate a redefining of trust between state and citizen and signal a step change towards true co-production of health and social care.

Find out more about Individual Service Funds and how they can be used on the Centre's project page

Look at the resources available on TLAP's website.

Download the practice guidance as a pdf: Individual Service Funds and Contracting for Flexible Support.


The publisher is the Centre for Welfare Reform.

Can ISFs Save Domiciliary Care? © Martin Walker 2016.

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.