The government must relax its 2013 target for 100% take-up of personal budgets in adult social care, according to the New Local Government Network.
In a report published today, the NLGN said that, although a move to personal budgets was a positive step for service users, rushing the reform could have disastrous consequences.
“We’re in favour of personal budgets, but we think the government should slow down the reforms and get implementation right the first time,” Daria Kuznetsova, author of the report, told Community Care.
Kuznetsova said in a lot of cases, personal budgets do not mean choice and control for service users because people are not given the choice of direct payments. Their budgets are handled by a care manager, which can be a choice in the personal budgets system, but in many cases it is not a choice and people are receiving the same care they were always receiving, she said.
“It’s just called a ‘personal budget’ to push this government target,” she added.
The think-tank’s analysis of council data showed that each additional direct payment issued to someone with a learning disability between 2002 and 2012 added between £15-25,000 to a council’s overall expenditure on learning disability services. Care for people with learning disabilities accounts for more than 23% of the adult social care budget, the report added, and represents the fastest growing part of that budget in the past five years.
The report argued that the only way to ensure affordable personalised services was to accelerate moves towards a new form of outcome-based commissioning. With a strong outcomes measurement system in place, it said, emerging commissioning tools such as payment by results and social impact bonds could be developed within adult social care.
“This will drive a focus on value for money, rather than simply cost, and it will help commissioners identify effective forms of intervention that help people with learning disabilities to live the lives they want to lead,” said Kuznetsova.
Kuznetsova said the outcomes measures should be determined nationally, leaving local authorities to develop the marketplace so that it is more consumerised.
“It’s already becoming more consumerised, with some individuals purchasing services themselves,” she said. “The problem at the moment is that information about how good those services are and what services are available is still held by a very select few. So there needs to be a broader definition of commissioning that includes this information sharing and market development.”
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