A very enjoyable seminar at OPM last night about the likely success of implementing personalisation on the timetable envisaged by the Government across a range of services (although focusing not surprisingly on social care). The seminar was arranged as a debate between proponents of the view that we are on course and those more sceptical. For the record, I'm largely with the latter but the really interesting points which were clarified for me in the discussion were that focusing on the budget may be to miss the main point.
Personalisation can of course be decoupled from personal budgets and there are a range of problems with passing budget management over to clients, sometimes exacerbated by the way in which information is made available (or not) and from a genuine fear for the individual of being overwhelmed. Indeed, arguably asking individuals to manage the budgets is unnecessary. The main point of personalisation is to give the client greater control over what is done. Provided they can do so, who manages the administration of the budget is a second order question and might often best be left in the bailiwick of professionals.
But it goes further:
- the personal budget is on current plans only ever going to cover a portion of the range of services needed to secure personalisation;
- the trigger for a personal budget is tied to eligibility criteria as care needs are assessed but personalisation is needed well before this point and is also needed by people who may not end up being assessed as eligible, particularly as budget cuts bite ever deeper.
Focusing only on the part of the package covered by the budget is an error for professionals and a problem for clients.
There were many interesting points about the potential for clients to pool their resources to secure greater leverage but also potentially to have a relationship with providers which may help to assuage some of the concerns of the latter about the implications of personalisation as block purchasing by councils seems likely to disappear over the hill. There remain some big questions about the way that such pooling might be undertaken and with what support - which might come from peer and user led organisations although they could then end up standing in the shoes previously occupied by the local authority. But again, this suggests that some rethinking on how budgets are held might be beneficial.
The other highly significant point is about what was variously described as the need to bolster 'buyer literacy' or, rather more colloquially, how to give many clients the first clue about what to do with a budget. This is often not being handled well at the moment. I'm currently working with an organisation which has volunteering as its whole raison d'etre and the scope for volunteers - with some training - to provide non-judgemental, one to one support that a family member might otherwise offer to help navigate through some of the more professional forms of advice which are available (although insufficiently) seems strong.
However it is done, securing what a contributor described as greater equity of support for different types of client seems absolutely essential and should be a pre-requisite for moving to providing a personal budget.
For me the main lessons from all of this are to focus on securing self-direction first with all of the cultural change that is needed on the part of professionals and providers and to put more emphasis on ensuring that there are proper support arrangements available for clients.
So maybe its not the money that matter most.