The challenges for councils in implementing the personalisation agenda are many, but it is an exciting time for those prepared to radically change an established system, writes Zoe Porter
When staff from 13 councils in England gathered together nearly three years ago for their first formal introduction to the individual budget pilot programme, there was a clear sense that they were about to embark on something exciting.
It is unlikely, however, that anybody could have predicted the speed or the intensity of the journey since then. Back then we had many of the key elements and principles of a model for personal budgets in place – developed and refined by In Control, and still fit for purpose today.
But the practical application of these had been limited to small numbers of people, and mainly to adults of working age. Two years later Putting People First heralded system-wide transformation, including personal budgets for everyone receiving social care funding except in emergencies..
The 13 pilot sites, together with councils taking part in the In Control Total initiative, have been pioneering a radical change in the way we relate to people who receive social care support. It takes a shift in culture, attitude, practice and systems. This can raise basic questions about issues such as what social care money should be spent on or how council IT systems can support very different information requirements.
Some of these challenges would be associated with any change of this magnitude – how to change hearts and minds, how to plan for an uncertain future. Some are a feature of our starting position – it’s not easy to develop a system of allocating resources that is transparent and equitable when it’s difficult enough to find out how money is spent on a person’s support in the current system.
In addition, we need to develop systems to ensure that people are safe when we have less control over the support they get.
These issues are being worked through now in 150 councils. Much of the learning from the individual budget pilot programme, and subsequent development work is available through the personalisation toolkit at www.personalisation.org.uk. The pilot programme evaluation report, due later in the year, will also provide helpful insight into many of these issues.
What of the 13 pilot sites themselves? At the beginning of the pilots, many were considering what their exit strategies would be. But before the publication of Putting People First last year, talk moved to how to extend the pilots. For all the challenges and anxieties, enthusiasm and commitment to the idea of personal budgets grew within the councils as, with excellent leadership from project teams, more staff got to grips with the realities of it.
For many of the pilot sites, considering how to scale up the project involved some stepping back and rethinking. It is relatively easy to operate a pilot under the radar and find clever solutions to make it happen, but trying to plan for complete system change, including prevention, early intervention and reablement, is another ball game. This is one of the reasons the Care Services Improvement Partnership worked with two of the pilot sites to develop the “planning for transformation framework” that provides the backbone of the personalisation toolkit.
Many of the pilot authorities continue to break new ground. In Barking and Dagenham, for example, they are working with health colleagues on a Unique Care pilot that identifies older people who are at most risk of hospital admission, providing early interventions, including personal budgets to help keep them well and maintain their independence. So far they have worked directly with 400 people, 30 of them having had a personal budget. Early data show promising signs that this is effective in keeping people out of hospital and improves their quality of life.
So we come to the next part of the journey and the task ahead. Conferences like Community Care’s Implementing Personalised Care in Adult Services on 24 September are one way that all those involved in making this change happen can share learning and ensure that we make full use of this opportunity to build a better social care system to support future generations.
Zoe Porter is deputy programme manager, personalisation, at the Care Services Improvement Partnership. She will be speaking at the Implementing Personalised Care in Adult Services conference on 24 September. Book a place now