Beyond Direct Payments published
Two new publications authored by Fellows of the Centre for Welfare Reform have been published by Think Local Act Personal (TLAP).
Beyond Direct Payments
Direct payments were intended to help people have choices and offer flexibility with how they manage their support. The reality is that for many, the extra work involved with having a direct payment does not make them an attractive or an easy option and people who receive direct payments can experience them as a burden. However there are alternative ways for local authorities to commission support that go beyond the limitations of direct payments.
In Beyond Direct Payments: making the case for micro-enterprise, Individual Service Funds and new forms of commissioning in health and social care, Simon Duffy, Centre for Welfare Reform and Anglea Catley of Community Catalysts discuss some of the different ways of commissioning support. They show that there are better ways to organise things so that:
- people can get flexible support
- people can be better connected to their communities
- social workers can work according to their core values
Micro-enterprises like those nurtured by Community Catalysts, Local Area Coordination, Social Prescription and the take up of Individual Service Funds (ISFs) are all cited as valuable examples. The authors argue that managers working in health and social care should support and promote these types of commissioning to help create a more diverse market to support people if a direct payment is not the preferred option. As the authors say:
“Personalisation was never meant to be about just spending a budget; instead it was supposed to focus on building on people’s gifts, talents and desires - not on professional conceptions of ‘need’ - and on outcomes that strengthen the spirit and resilience of the person and their family...”
Ten Tips on ISFs
At the same time TLAP have also published guidance to commissioners on how to help implement ISFs.
Chris Howells, a Fellow of the Centre, has written Progress and pitfalls in Individual Service Funds – ten tips a summary of the lessons learned to date on the implementation of Individual Service Funds in the West Midlands. These tips are based on the practical work by commissioners to reform their procedures for tendering and procurement to enable individual choice and control.
Christopher Watson, Joint Commissioning Manager at Dorset Council, and also a Fellow of the Centre said:
“In practice Individual Service Funds allow a far greater degree of choice and flexibility than traditional commissioned services and, in some ways, they can be easier to manage with less administration than Direct Payments. In Dorset we have already seen the ISF approach deliver real and tangible benefits for people by helping them to understand their personal budget, which can give them and their chosen provider the flexibility to co-design how their outcomes are best met. Other organisations can deliver elements of support and there is the opportunity to pool some or all the funding with friends, who may be supported by other providers, but have similar identified outcomes.”
Rachel Mason, parent and direct payment holder, and also a Fellow of the Centre, said:
“Those of us with direct payments are no-longer passive recipients of services commissioned for us, often on block contracts from a provider who won the tender on a procurement framework; we are purchasers and ‘customers’ of local responsive support from one or many different local and visible micro-provider services, whose reputation and transparent accountability, keeps their quality and standards high. This level of self-direction can at last be achieved without having to take on the responsibility of a direct payment. People can ask for an Individual Service Fund, where the provider holds and spends their budget in collaboration with the person.”
Dr Simon Duffy, Director of the Centre said:
“It is very positive to see TLAP encourage local authorities and the NHS on this issue. The tendency to confuse direct payments with personal budgets and the ongoing failure to offer people less onerous ways of managing their personal budgets undermines the aspirations of the Care Act and official policy. Instead too many commissioners are relying on systems of tendering and procurement which are both wasteful and an abuse of people's human rights. Some cite EU Procurement rules as the reason for continuing these practices, but most European countries never apply such clumsy tendering regimes to social care. There is no need to continue with this policy and we already possess the legal and practical frameworks to make competitive tendering in social care redundant.”
The Centre will be publishing a further practical guide on ISFs, on behalf of In Control Scotland and in association with Citizen Network, on 28th February.