Looking for the win, win, win

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

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Last Updated : 16 February 2012. Page Author: Laura Bimpson.