News

With the drive to run social services departments on supposedly more business-like models incorporating financial discipline, it is no coincidence that community care panels' role has become pivotal.

If an adult service user is assessed to need a complex care package or residential or nursing care (either permanent or short-term), chances are such services and their costs will need to be approved by a community care panel. It's a powerful management tool that can centralise decision-making and provide a strong budgetary control.

With the ability to approve, defer and reject, a panel needs to be well managed to be in tune with the levels of needs that can be met, based on what is affordable.

"Our panel meets every two weeks to consider about 70 cases each time," says locality manager Robina Critchley, who chairs one of two panels (the south) in Sefton, Merseyside. The panels are geographically split, with Southport and Formby in the north, and Crosby, Bootle and Litherland in the south. The two panels are also coterminous with the borough's two primary care trusts.

As panel chair, she is joined by team managers from all adult services, and for the past year by a senior nurse from the primary care trust who manages the continuing health funding. "Not many panels have nurses on them, but they act as advisers checking out nursing assessments and answering any health queries that we have," says Critchley.

Each fortnight cases are presented to the panel to bid for the available allocation. "Sometimes we have a talk about things but the care managers are very good about prioritising cases against the fair access to care services - the national eligibility criteria. They largely sift out those cases that don't meet the criteria before getting to panel. It is quite a tight ship now. Money is monitored more closely," she says.

And to keep that tight ship afloat, Critchley realises that money has to be spent against centrally set targets. "We have priorities. For example: not to block hospital beds, which might mean using different resources such as intermediate care. You look at risk assessments and ask, 'What can people manage with?' and so on."

With a trend towards more and more complex needs, a word Critchley regularly looks to is "differently". She says: "One of the things we are good at now is that we hardly ever place adults with disabilities or mental health needs in long-term care: we use money differently.
People are directed towards direct payments, supporting people or independent living fund. We look differently at funding respite care so the carers can have a break."


With care management in Sefton under review, Critchley believes the biggest challenge is "trying to get staff to think more of assessment of need. We need to be more inventive when we're with someone and start thinking about how can we meet their needs rather than resorting to a catalogue of care."

Also Critchley is keen on pushing direct payments. "We tend to use them for complex cases. But why not use them for simple, straightforward cases? They were complicated to begin with but we've made using them easier. We've moved them into our carers' centre, so it's not run by us as such and makes it more accessible to carers," she says.

Critchley believes that "the panel is the best way we have at the moment, but it's a question of whether you devolve budgets down to a team manager. However, that lessens the scope you have - and you can become very blinkered into thinking there's just your team."

With Critchley a mainstay of the panel - albeit in different roles - since 1995 in an uncertain social care world, people at least know what to expect. "People get used to your style, don't they? They know what questions I'm going to ask before I ask them sometimes," she smiles.

CURRICULUM VITAE
NAME: Robina Critchley
JOB: Locality manager, Sefton social services.
QUALIFICATIONS: Teaching certificate, BA Social Sciences, CQSW, Certificate in Management.
LAST JOB: Team manager.
FIRST JOB: Administration officer in adoption section.

TOP TIPS

• Get all new assessment staff to attend panel as part of their induction.
• Ensure team managers screen all assessments.
• Ensure accurate financial information is available.

RUBBISH TIPS

• Don't worry unduly about budgets - everything will work out.
• Don't explore alternatives - stick to what you know.
• Let everybody vote with a show of hands on all decisions.