I paid a visit to Devon last week to hear about a wholesale reform of care management that seems to be bearing fruit in terms of better outcomes for users and lower costs.

Essentially, they've examined the care management role, defined what required social work skills and what did not. 

In future, lower-level assessments and care planning will be handled by telephone largely by former referral co-ordinators and community care workers (plus the odd social worker). Social workers are thus freed up to concentrate on more complex cases where they work alongside health professionals in fully integrated teams with fully joined-up management.

Services are then arranged by brokerage teams, including some people with social care experience (though not necessarily social workers) and others with a financial/procurement background.

I was just wondering if anyone had come across a reform like this in their area? Does it sound good to you?

I am an Occupational Therapist working in Devon, and so am heavily involved in the current reform going on.  I am interested to hear that David Johnstone has informed you that half the OT jobs will be cut, because we haven't been informed of that. Yesterday our fate was being discussed amongst our Senior Managers, and we have yet to hear the final outcome.

I think working closer with our health colleagues is the way forward, and there are a lot of the benefits I can see. However I do have serious concerns about people being assessed over the phone, and reducing the face to face contact with our clients.  I do agree that there will be some people who can be managed in this way - but not the percentages that I have heard claimed (ranging from 60-90%). 

Hi Emma

Do you think it's all just a cost-saving measure?

I think it is a cost-saving measure which fits in part with those government initiatives and white papers such as the individualised care budgets, my choice my life, putting people first etc. However, in Devon they are talking about a reduction of 50 full time equivalent posts in Adult services (physical disabilities and older peoples mental health), and the majority of those are front-line workers with possibly 30 being Occupational Therapists (although as I have said before this has not been confirmed yet). I personally feel that the government initiatives about managing people with complex needs in the community, preventing hospital admissions, etc. doesn't seem to fit with this proposed decimation.