Many signposts but no direction

Are government proposals for providing advice as joined-up as
they should be?

Care Direct is the proposed one-stop gateway to information
about social care, health, housing and social security benefits, to
be piloted next year in six local authorities in the South
West.

The key elements are:

• One telephone number, which will pass callers on to local
  helpdesks in local authorities. Callers can also use these local
  helpdesks or make contact through outreach facilities.
• The helpline will be run by NHS Direct call centre staff.
• The local helpdesks will give information about the four core
  services and provide practical assistance to help people gain
  access to these services and claim social security benefits. This
  could include helping them to complete forms.
• The Care Direct helpdesks will be augmented by online
  facilities, linked to local authority and other websites, as well
  as volunteer befrienders.

Subject to full evaluation of the pilots, it is expected that
Care Direct will become available in a further 30 local authorities
in 2003-4 before going nationwide.

Care Direct will have many implications for local welfare rights
and advice activity. NHS Direct staff will act as the initial
filter – what will they know about benefit matters? Who will staff
the local helpdesks and outreach facilities? What benefit knowledge
will they have? What kinds of forms-completion service will they
offer? What will be the role of volunteer befrienders?

The proponents of Care Direct seem to have a simplistic view of
the benefit claim process. Skilled interviewers often take an hour
face-to-face to complete a form in clients’ own homes, for example.
What they hear from clients is then supplemented by what they can
see of clients’ abilities. Helplines and multi-purpose information
points do not offer the same quality of service. But with Best
Value reviews being used in many areas as a cover for reducing
advice services, Care Direct could be another threat to the
specialist advice sector.

Of course, Care Direct could be an opportunity for advice
services and staff as well as a threat. It gives a legitimate and
government-funded toehold in areas where advice provision is
lacking. It also appears to take the Benefits Agency out of the
advice-giving loop, which may be no bad thing either.

But how does it fit with other similar initiatives?

Only last week, the government also announced that 18,500 post
offices are to become one-stop government shops. Postmasters will
become government general practitioners by providing a gateway to
central and local government services. They will offer low level
advice and information on benefits, social services, council
housing, employment and education – in other words, many of the
same services as Care Direct.

In addition, the new Pensions Agency has a target of
establishing a primarily phone-based service, as exemplified by the
minimum income guarantee phone-line. The Legal Services Commission,
through local Community Legal Services Partnerships, is also
setting up a network of advice agencies, including telephone
helplines.

With many local authorities developing their own call centres
and one-stop shops, it seems that there will be a multitude of
places that a person can ring or go to for initial advice.

But is enough attention being paid to the follow-up service?
There is a real danger of Care Direct adding to other similar
services, without the infrastructure being put in place to provide
the back-up. Will it prove a case of all froth and no beer?