Editorial Comment: Direct payments flagging

Direct payments are supposed to give service users more control and choice over their services. The number of people using them has grown considerably since 2003, with the requirement that they be offered to everyone assessed as needing social care. But a report shows take up varies hugely between councils and client groups and, overall, it remains relatively low.

It raises serious questions about equality of access and cannot simply be attributed to lack of demand.

Direct payments have major implications for how services are commissioned and delivered, and many councils – with their money tied up in existing services – are struggling to respond. The report points to several barriers to success.

Direct payments need strong, preferably independent support services to be successful, but investment in this is declining. Furthermore, the rates of pay they offer are often proving too low to attract good personal assistants.

But, more worryingly, the report claims that care co-ordinators are stymieing progress because of heavy work loads and a lack of understanding. If we want to accelerate the spread of direct payments it has got to be made easier for social care teams to develop them.

Centrally imposed duties are only going to go so far with a profession that is already running to stand still.

Efforts to communicate best practice in this area need to be renewed, and the real costs of transformation have to be met. This is vital if individual budgets, of which direct payments are a key component, are to become the successful next step in empowering the service user.

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User group attacks councils on direct payment support

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 Mike Broad

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