A job at Sellafield for British Nuclear Fuels following a business degree is one of the more unusual career jump-off points for a social service director. But that was where Martin Farran started out en route to his current role as Barnsley council’s executive director of adults and community services and one of the foremost champions of personalisation in local government.
His transition from nuclear energy to social care was sparked by a stint volunteering with disabled people and people with mental health problems that led him into the voluntary sector and then into statutory services. Before taking on his current role in 2007, he was a senior manager working across adults’ and children’s services at East Riding of Yorkshire council.
Farran is the Association of Directors of Adult Social Services’ lead on personalisation and Barnsley has been at the forefront of the agenda, piloting both individual budgets and the Right to Control scheme to provide disabled people with integrated personal budgets across several services.
He has also argued strongly for policy change to more firmly embed personalisation in practice. For example, last year he joined organisations such as In Control in calling for the government to legislate for people to have an entitlement to support planning regardless of their eligibility for care. This would enable people to draw on their informal networks and supports to maintain their independence and achieve their goals, shifting the care system away from crisis intervention towards prevention.
From personalisation to integration
Having championed personalisation, Farran is now at the forefront of the current reform imperative for the care system: integration with health.
Barnsley is one of the 14 integrated care pioneers chosen to test new ways in which health and social care can come together to help older and disabled people stay independent and reduce pressures on hospitals and admissions to residential care.
Barnsley has set up a monitoring centre to receive alerts about people needing emergency support and dispatch appropriate support, such as an assessment from a mobile response unit, for emergency cases to ensure they get appropriate help such as assessment from a mobile response unit, day-to-day support to stay independent at home or extra information about services.
Farran says the project has not been running long, but some useful lessons are emerging from it.
In particular, he says, there needs to be provide proper information and advice for the public on what services are available aside from hospital and what else people can do to take care of themselves. “We do not spend enough on early intervention, prevention, information and advice so the system has too many people in it who do not need those [acute] services,” he says. “In most places that information and advice is probably fairly weak and fragmented and we need lots of different levels and types of intervention and support.”
He gives a wide range of examples of preventative and rehabilitative services, which could take pressure off hospitals. They include telecare and equipment for people with disabilities, advice on how to deal with a condition, help to regain skills and confidence after an illness, and activities that help people feel less lonely.
Providing these additional advice and care services will take the strain off the NHS, says Farran, but will require money being moved from one part of the system to another.
“The way to do that is to reduce hospital beds so we can invest in other services,” he says. “If you do not do that the system will be in crisis.”
Interestingly Barnsley’s pioneer project does not include a full scale merger of health and social care teams. “If all you do is create joint teams but offer the same service it does not change anything for the patient,” says Farran.
Asking the public what it wants
Farran feels the experience of implementing personalisation has lessons for the integration agenda. One is the need to find out what people want from services when re-designing them. Services designed to take the pressure off accident and emergency departments have to be seen as better and more responsive than A&E by people going there unnecessarily, to convince them to switch to the new service. “The reason people go to A&E is because they get a response even if they sit there for hours,” he says. One might expect the public to come up with a wish list of costly services, but Farran says personalisation showed that people often want things that are relatively small and inexpensive.
There is plenty the NHS can learn from personalisation too, he adds. “Personalisation is the default position for social care,” he says. “I would like that extended across health and particularly mental health. We could free up a lot of resources for better outcomes and at a lower cost.”
There are even parallels between personalisation and social care management. Personalisation is about enabling people to make choices about their care. Similarly good management is about not being too controlling. “Good managers are enablers, they are facilitators,” he says. “We have not not to be overly concerned that we have the answers to everything. We have to be inviting the right questions and giving people scope to come to different solutions. Sometimes people come up with something I would never have come up with myself in a month of Sundays.”
Martin Farran on…
A social care leader must be… optimistic, inclusive and inspire others. It is not about them having all the answers; it is about them being someone who wants to work with others. Do not assume things, ask people.
If I wasn’t a social work director I’d be…involved in some other people-based activity. If I had thought about it at the time I would have been interested in psychology.
I’m most inspired by… some of the things people achieve and how they change their lives.
My staff describe me as…someone who can inspire people and is approachable.
What keeps me awake at night…my wife snoring.
The government could make my job easier by…bringing the NHS and local government closer together, particularly the resources. We still have two systems and the cultural difference between local government and the NHS is quite big.
I’m proudest of…some of the things we have achieved in terms of personalisation in Barnsley both through some of the services users and the staff who support them.