Service user budget holders could be priced out of services

Personal budget holders could have their choice and control “critically undermined” by being priced out of the services that they want to access.

That was the warning from think-tank Demos in a report today that it billed as the biggest study of users’ opinions on personal budgets, based on a survey of 770 people across 10 councils.

The study, released to coincide with the government’s adult care vision, found that personal budgets would result in a transfer of care funding from traditional services such as day care to universal and mainstream services such as leisure or holidays.

Of surveyed users already on personal budgets, 21% used them to fund holidays, up from 6% who had used their care funds for holidays before receiving their personal budget. Thirty-seven per cent used their budget to fund leisure services, up from 14% who had previously had leisure funded from care resources.

Of those currently receiving council-commissioned care, 73% said they would spend a future personal budgets on leisure and 44% said they would use them for holidays.

However, Demos warned that councils would face a challenge of ensuring these services were affordable, accessible and suitable for service users, particularly in expensive areas such as central London.

This would be exacerbated by reductions in social care spending on the back of last month’s government spending review, which will reduce real terms funding for councils by 28% from 2011-15, partially offset by an extra £1bn a year for adult care from the NHS.

“If care users cannot afford to access the services they say they would like to use with a personal budget, then choice and control – the raison d’être of personal budgets – will be critically undermined.”

Its concerns were backed by findings regarding the 138 self-funders surveyed, 42% of whom said they would like to change their care and support if they could, suggesting that having control over finance may not be sufficient to exercise choice and control.

Demos also found that council commissioning strategies would have to balance helping users access to new services while also maintaining traditional care provision, as 45% of people receiving council-commissioned care said they would not change their care package when they received a personal budget.

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