Difference in need

With the drive to run social services departments on supposedly
more business-like models incorporating financial discipline, it is
no coincidence that community care panels’ role has become

If an adult service user is assessed to need a complex care package
or residential or nursing care (either permanent or short-term),
chances are such services and their costs will need to be approved
by a community care panel. It’s a powerful management tool that can
centralise decision-making and provide a strong budgetary

With the ability to approve, defer and reject, a panel needs to be
well managed to be in tune with the levels of needs that can be
met, based on what is affordable.

“Our panel meets every two weeks to consider about 70 cases each
time,” says locality manager Robina Critchley, who chairs one of
two panels (the south) in Sefton, Merseyside. The panels are
geographically split, with Southport and Formby in the north, and
Crosby, Bootle and Litherland in the south. The two panels are also
coterminous with the borough’s two primary care trusts.

As panel chair, she is joined by team managers from all adult
services, and for the past year by a senior nurse from the primary
care trust who manages the continuing health funding. “Not many
panels have nurses on them, but they act as advisers checking out
nursing assessments and answering any health queries that we have,”
says Critchley.

Each fortnight cases are presented to the panel to bid for the
available allocation. “Sometimes we have a talk about things but
the care managers are very good about prioritising cases against
the fair access to care services – the national eligibility
criteria. They largely sift out those cases that don’t meet the
criteria before getting to panel. It is quite a tight ship now.
Money is monitored more closely,” she says.

And to keep that tight ship afloat, Critchley realises that money
has to be spent against centrally set targets. “We have priorities.
For example: not to block hospital beds, which might mean using
different resources such as intermediate care. You look at risk
assessments and ask, ‘What can people manage with?’ and so

With a trend towards more and more complex needs, a word Critchley
regularly looks to is “differently”. She says: “One of the things
we are good at now is that we hardly ever place adults with
disabilities or mental health needs in long-term care: we use money
People are directed towards direct payments, supporting people or
independent living fund. We look differently at funding respite
care so the carers can have a break.”

With care management in Sefton under review, Critchley believes the
biggest challenge is “trying to get staff to think more of
assessment of need. We need to be more inventive when we’re with
someone and start thinking about how can we meet their needs rather
than resorting to a catalogue of care.”

Also Critchley is keen on pushing direct payments. “We tend to use
them for complex cases. But why not use them for simple,
straightforward cases? They were complicated to begin with but
we’ve made using them easier. We’ve moved them into our carers’
centre, so it’s not run by us as such and makes it more accessible
to carers,” she says.

Critchley believes that “the panel is the best way we have at the
moment, but it’s a question of whether you devolve budgets down to
a team manager. However, that lessens the scope you have – and you
can become very blinkered into thinking there’s just your

With Critchley a mainstay of the panel – albeit in different roles
– since 1995 in an uncertain social care world, people at least
know what to expect. “People get used to your style, don’t they?
They know what questions I’m going to ask before I ask them
sometimes,” she smiles.

Robina Critchley
JOB: Locality manager, Sefton social
QUALIFICATIONS: Teaching certificate, BA Social
Sciences, CQSW, Certificate in Management.
LAST JOB: Team manager.
FIRST JOB: Administration officer in adoption


  • Get all new assessment staff to attend panel as part of their
  • Ensure team managers screen all assessments.
  • Ensure accurate financial information is available.


  • Don’t worry unduly about budgets – everything will work
  • Don’t explore alternatives – stick to what you know.
  • Let everybody vote with a show of hands on all decisions.

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