Soon we will have Putting People First 2.0 –a new vision and concordat for personalisation. What progress will it report and which aspirations will survive the brutal financial circumstances, asks Alex Fox?
In some areas, the most visible change is in how the money moves around. Councils have dazzlingly complex resource allocation systems to generate personal budget allocations, but the same narrow range of services from which to choose.
When I ask our Shared Lives schemes about the impact of cuts, some areas have imposed a freeze on referrals while others are trying to increase referrals on the basis that we’re cheaper than alternatives. In both cases, commissioners are moving large blocks of money and resource, rather than trying to create a range of providers in response to local needs and choices.
We still have complex “framework” commissioning agreements, “reverse auctions” (cheapest provider wins), an area where care managers say they can purchase only from one-star providers (presumed to be cheaper than higher rated competitors) and a council where you can get your assessed level of day care from an existing provider, but because budgets are committed to these block contracts, much less if you opt for a personal budget.
A personal budget makes you a consumer, not a commissioner. The power to shape provision will only come when budget holders and their families come together to take ownership of providers and commissioning bodies. If parents can set up “free schools”, why can’t disabled and older people set up their own services?
A good example is a community interest company that supports disabled people. Its directors are two disabled people, two family carers and one professional. Will the vision suggest more consultation and “co-production”, or will it open up the system to these new providers, share risk with them and regulate appropriately?
Alex Fox is chief executive of Naaps, the UK network for Shared Lives and small community services
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