For provider organisations, working to adapt to personalisation
at a time of shrinking resources can be a real challenge.
Shifting systems, practices and behaviours in response to personal
budget holders and more broadly personalising support for people
using provider supports would be hard at the best of times. Many
are rising to this challenge, however, and although the "crisis is
an opportunity" idea can be badly misused it is clear that for some
innovation is being driven in part by the financial
pressures. I had the pleasure some time ago to be asked to
join some of the initial thinking being done by a small group of
providers of support to people with learning disabilities who were
determined not to be passive victims of resource reductions. They
wanted to ask the question "How can we defend and even extend our
mission to support the inclusion of disabled people as money gets
tighter?"
Over a couple of years they worked together and inside their own
organisations, to develop and then implement ideas that were
generated. Some of these were about changing how staff resources
were deployed or use of technology. More radically for the
organisations involved, others were about helping people build
their community connections and thus reduce reliance on paid staff.
This was something they had not previously achieved to their
satisfaction as staff had tended to be seen as necessary to most
activity. Some of the learning from this on-going work had been
captured in the paper
Altogether Now. As the title suggests a key element of this
work was that there were three key partners - people using support,
the providers and their commissioners. The provider leaders knew
that they must base ideas and changes on what was important to
people, hear their ideas and co-produce developments. Equally they
knew that although many of the changes were within their gift,
others would require help from commissioners, or at the very least
that commissioner behaviours would not hinder the developments.
In these tough times I often hear providers express frustration
with commissioners' approaches to managing reducing resources which
sometimes don't take a partnership approach - telling providers how
resource reductions will take place rather than working it out
together. Some providers say that they are treated as if they were
the suppliers of widgets rather than partners in ensuring people
get good support. One provider, for example recently told me that
his organisation were supportive of their commissioner's wish to
disaggregate a block contract but felt the complexity, risks and
time involved in doing this were not acknowledged with potentially
damaging consequences for all involved, especially the people using
support.
However it doesn't have to be and isn't always like this. At a
recent event between commissioners and providers looking at how to
move forward with personalisation there were also much more
positive examples. These always started with a sense of a three way
partnership, with people knowing that resources are pressured but
listening to what is important to people and looking for collective
solutions. This led some of us to start to think about what are the
approaches and behaviours between providers and commissioners, in
co-production with people using support, that could lead to the
best results? A piece of work is now underway in the North West to
explore and identify these positive behaviours with a view to
sharing and encouraging them. The idea has also been taken up
nationally by Think Local, Act Personal. Watch this space for what
emerges - hopefully not just a win-win, but a win, win win!
Martin Routledge
Last Updated : 16 February 2012. Page Author: Laura Bimpson.
