Our experience of Personalisation – part 2
Wednesday, June 15th, 2011
I wrote last week about our experience of Personalisation. I talked you through the early stages of the self-directed support process, highlighting some issues that we’d come up against at each stage. I’ll continue now with the next stages of the process, before considering what to do to change things for the better. Again, your thoughts and experiences – in particular any examples of where things are working well - would be much appreciated.
- Let’s look first of all at the support planning and brokerage stages. We’ve witnessed a lack of creative thinking here. There’s lots of terminology here – and how this is done differs in each local authority area. But the basic idea is that a person is supported to work out how best to meet their desired outcomes (support planning). They can then be supported to find creative, person-centred ways to meet those outcomes, by identifying appropriate services to buy (brokerage).
We are finding that, even though support planning and brokerage can, in theory, be done by organisations outside of the social care system (eg an older people’s support network could do it for one of their members) the majority of this work is done by social workers. Social workers who are under immense pressure, and have very little time. Social workers who are accustomed, however person-centred they may be in their philosophy, to offering people what the system can offer. It’s hardly surprising that (according to anecdotal evidence) the majority of people going through this process are ending up with pretty much what they had before. In other words, services which the system can deliver.
Let’s just pause and think about that for a while. So a load of money, time and effort is being put into this, and it seems that a majority of people are coming out with what they always had. Isn’t that a bit ridiculous, even if we accept that some people may actually be quite happy with what they had? Well, what might seem more ridiculous is that, statistically at least, this person counts as someone who has accessed a Personal Budget (and until April 2011, councils received a financial incentive for getting people onto a Personal Budget in this way). Even though nothing has changed for them, and the council still manages their money (sometimes spending it only on services provided by organisations with whom the council has framework agreements (contracts). This is what is often referred to as a Virtual Budget. This statistical massage is why Ministers can confidently proclaim that all is well with Personalisation.
- One of the things councils have been charged with is stimulating a market in social care. They are required to produce what are called Market Position Statements – in order to communicate with other providers (third sector, private sector) how they would like to see the market develop. In one area where we’ve done some work in the past, the consultation event on the Market Position Statement has been postponed twice, and we’re still waiting for a new date. That’s not a great way to stimulate a market.
But how do you stimulate a market? I think it’s a really hard thing to do. And to be fair to the councils where we’ve worked, they’ve each put money into encouraging third sector organisations to set up services. But at the same time, they’ve been less than forthcoming with the kind of information which would give organisations confidence to take the risk in setting up services. Simple information, like how many people in the city have got a Personal Budget, and how many of them ended up with services which were materially different to what they had before.
So you can understand why, when they don’t get answers to these questions, organisations may assume that few people are being enabled to access new services. If this is your perception, you’re hardly likely to set up a service are you? Which, of course, means that there are fewer services to choose from – which makes it more likely that people will go for what they’ve always had. And so we go on.
We do what we do because we want to make a difference. I write stuff like this not to point the finger, but to acknowledge that things aren’t working as they could do. I think, with a policy as radical as Personalisation, it’s natural that things will take a while to work out. But you need to feel that things are at least moving in the right direction – and that issues are acknowledged.
I think that recently people are starting to publicly acknowledge that we are struggling to make Personalisation work. I really think we need more openness about this. But it doesn’t come naturally to local authorities to admit that they don’t have the answers.
What are we doing about this? We’re continuing to work on Personalisation (some paid work, some speculative work) – and in particular we’re focusing on what we’ve called Personalisation – Made in…. We ran a Personalisation – Made in Bradford open space event earlier this month – and we’ve set up a network in Leeds too. The idea is to bring different people together – who all have a stake in making this work. Service providers, people who receive social care support, investors, service designers, social workers. We believe that we’ll find ways to make Personalisation work by bringing people together to discuss issues openly, and then collaborating to make the system work for people.
