The way individual budgets for older and disabled people will work in practice is to be developed at 13 pilot councils, announced earlier this week by care services minister Liam Byrne.
The 13 local authorites are Barking and Dagenham in London, Barnsley, Bath and North East Somerset, Coventry, Essex, Gateshead, Kensington and Chelsea in London, Leicester, Lincolnshire, Manchester, Norfolk, Oldham and West Sussex.
Councils will share £2.6m to set up systems and run pilots for between 18 months and two years. These are expected to start early in 2006.
“Individual budgets will help vulnerable older and disabled people take control and choose the services that suit them best,” said Byrne.
The idea of individual budgets for service users is universally praised as a good idea. But how will it work in practice?
Lessons have been learnt from the experience of direct payments, where take-up is patchy. Unlike direct payments, service users with individual budgets can ask councils to hold and administer payments for them. Service users can also buy council-run services with personal budgets, which they can’t with direct payments.
Finding and employing people and making payments has put service users off direct payments, especially older people, so more flexible individual budgets are welcome, says Jenny Owen, service director for adult social care at Essex Council.
Essex’s pilot is working with people with learning difficulties and people with physical disabilities.
Important tasks ahead, says Owen, include defining the role of care brokers, who will support service users with budgets and purchasing. Who will employ care brokers? Could it be the voluntary sector or service user-led organisations?
Councils will also need to monitor that money being spent as part of personal budgets is meeting the needs of service users, explains Owen.
Providing the right level and quality of information to service users so they can run their own budgets is another vital task, adds Owen.
Gateshead Council’s pilot is with service users in transition: disabled people moving onto older people’s services and young people going from children’s to adult services. The pilot is a great opportunity to modernise, says Margaret Whellans, head of services for people with disabilities at Gateshead Council.
Whellans is enthusiastic about individual budgets and says the scheme is a good way to offer clients a flexible “mix and match” of services with many varied options to meet their needs.
“We don’t have lots of money sloshing about and this is a good way to use the cash we do have differently. What we currently offer suits some service users but not others but now we should have more choices. Instead of residential care, perhaps a client might choose supported living in their own home, with short breaks,” she says.
Nic Rowland-Crosby, consultant with consultancy and development agency Paradigm, believes the pilot local authorities are whole-heartedly embracing this new way of working. But the logistics need serious attention, he says. Extracting councils from long-term block contracts with existing care providers will be tricky, says Rowland-Crosby.
Whellans at Gateshead Council agrees that decommissioning current services and recommissioning new ones will be a “challenge.”
Supporting less able service users to run individual budgets will be vital, according to Rowland-Crosby. “Mechanisms for keeping control of your own care could be complex and daunting,” he says.
Whellans points out that individual budgets are not for everyone and says how and if they are taken up will depend on the needs of service users.
When clients first come into contact with the council, which could be during a crisis, may not be a good time to suggest the idea of an individual budget. But over time service users could take control over some or all of their care package, says Whellans.
Some who are used to depending on council services and feel comfortable may find it very difficult to change and prefer to stay as they are, she says.
It would seem that slowly does it and gently does it will be good mantras for the pilot local authorities testing out individual budgets over the next two years.