World-class commissioning is central to the personalisation agenda, writes the Department of Health’s John Bolton
Putting People First, the concordat between government and the care sector on the transformation of adult social care, sets out the conditions needed for personalisation to flourish. It highlights four key components: access to universal services, early intervention to keep people independent, self-directed support and supporting people to be part of the community. New approaches to commissioning are important to each of these.
Universal services such as transport, leisure, education, health, housing, community safety and access to information and advice are important in everyone but they may have special importance for people with care and support needs. Councils and their partners should ensure that the planning and development of all services consider the implications for people with care and support needs.
The second area is the support available at an early stage for people who need help to stay independent for as long as possible. This includes things like support to recover from the effects of illness, help to manage a long-term condition, help to maintain home and garden, training to get a job, returning to work after a break, or starting to take some exercise. Not only do these early interventions make sure people can stay in their own homes for as long as they want, but they are also the best way of keeping the costs down in the future. Councils should be working with their primary care trusts to commission the services that will gain the outcomes that can be achieved through prevention and early intervention.
The third part is about self-directed support having services available to meet people’s needs rather than people having to fit in with the things on offer. People who need support and their family carers should be able to choose who provides that support, and control when and where the services are provided. The right information needs to be available to help people decide.
Systems should be easy to follow and everyone involved should work together with the person at the centre of their plan. To do this planning, people need to understand the money that is available to spend on their support and the options there are for how that money is managed and spent. People need to know what support there is locally, and that it is of a high quality and safe for them to choose. They must show that the money they have been given is making the difference it was supposed to make (the agreed results) through person-centred reviews.
There needs to be a local set of suppliers with a range of services and an approach to services that helps people make a real choice. Councils should move away from an emphasis on purchasing services and instead focus on ensuring that there is sufficient supply of the range of services that people may wish to choose, including services that help people to navigate the market for themselves. The care plan will focus on the results to be achieved and so the relationship between the council, the service user and the provider should focus on those same results. Councils should also consider how they work with the primary care trusts and local providers on joint workforce development programmes.
The fourth part of Putting People First is about how society works to make sure everyone has the opportunity to be part of a community and experience the friendships and care that can come from families, friends and neighbours. This should be done without putting an unreasonable burden on friends and family who want to help. Carers need to be recognised and supported.
Commissioning plays a major part in personalisation. This ranges from the responsibilities of councils for the well-being of communities to ensuring that there is the right supply of local services that can help meet the results people specify in their support plans. World Class Commissioning for social care is at the heart of reshaping communities and the services that are needed.
John Bolton is director of strategic finance at the Department of Health