Councils will be expected to slash the bureaucracy surrounding personal budgets in regulations and guidance under the Care Bill, it was revealed today.
Local authorities will be expected to reduce their use of funding panels, preferred provider lists and reporting requirements on service users receiving direct payments under the provisions.
Draft guidance and regulations will be published in May with the final versions agreed by October. A “minimum process framework” will also be published in October, setting out how councils should reduce levels of bureaucracy tied to personal budgets.
The policy was set out in a personalisation action plan published today by Think Local Act Personal, the Department of Health-funded sector partnership whose remit is to support the implementation of personalisation.
The plan is the result of a summit convened by care minister Norman Lamb last September to tackle some of the barriers to implementing personalisation in general and personal budgets in particular that have emerged in recent years, including council bureaucracy.
In a blog post for TLAP to accompany the plan, Lamb said there had been good progress in improving access to personal budgets – which are now held by most service users and carers – but warned of “restrictive practices that limit choice”.
These include the use of funding panels to sign off personal budgets, rather than giving social workers and team managers autonomy to do this themselves; multiple, duplicating forms covering assessment, resource allocation and support planning; the use of preferred provider lists to limit the range of services that people can use; and limiting how people can spend their direct payments or placing strict requirements on them to report their spending.
The debate over personalisation and bureaucracy
Successive surveys of social workers by Community Care have identified bureaucracy as the chief barrier to the successful implementation of personalisation. Just 10% of respondents to last year’s survey said their council had taken action to reduce bureaucracy in the previous year.
Leading advocates of personal budgets within TLAP have also raised significant concerns about bureaucracy, drawing on the findings of the 2011 and 2013 National Personal Budgets Surveys of service users and carers, commissioned by the partnership.
Both identified a strong link between good outcomes and less bureaucratic council self-directed support processes.
Some commentators, notably service user activist and social work academic Peter Beresford and social care consultant Colin Slasberg – have gone further and argued that there is something inherently bureaucractic in the self-directed support process.
In research published last year, and updated this year, they concluded that the model of providing people with indicative personal budgets following assessment was fundamentally flawed as councils were generally carrying out a separate process to calculate the final budget after costing the service user’s support plan.
However, this view is rejected by TLAP’s leaders, who have argued, citing the National Personal Budgets Surveys, that personal budgets generally improve outcomes for service users and do so to the greatest extent when bureaucracy is minismised. For their part, Slasberg and Beresford reject the surveys findings on the grounds that respondents disproportionately received direct payments, rather than managed personal budgets, and people with direct payments tend to achieve better outcomes.
Government to fund councils to check personal budgets outcomes
As part of today’s announcement, the DH has said that it will provide funding for all councils to use the personal budgets outcome evaluation tool (Poet), developed by charity In Control and Lancaster University, to assess the impact of self-directed support in their area.
Poet is the method used in the National Personal Budgets Survey, but last year only 22 councils took part, a number that TLAP and the government is looking to increase substantially. The level of funding per council to use Poet has not been disclosed as yet.
Lamb also announced that the DH would fund the TLAP partnership for a further period, from April 2014. TLAP has been consulting on a new partnership agreement setting out its programme of work for the next three years. This is due for publication next month.
Other measures set out in the personalisation action plan include:
- publishing a report in May identifying good practice in delivering personal budgets to older people to advise councils on addressing barriers set out in a previous report last year from TLAP and the Social Care Institute for Excellence;
- setting out how councils should look to promote a diverse market in social care through guidance and regulations under the Care Bill, published in draft form in May and in final form in October;
- testing how resource allocation systems can be made more transparent and less bureaucratic through work led by In Control in the North West and the Eastern Region.