Personal budgets - changing trains?

You'll remember Sliding Doors the film - where Gwyneth Paltrow has two different lives depending on whether she catches a certain train or not. I'm feeling a bit like that with personal budgets. We know that personal budgets done properly work better for most people than more traditional service offers (with lots of agreed caveats about making them accessible to all). The recent POET report shows that even given the frustrating and restrictive processes people are facing they still get significantly better outcomes - especially via direct payments. There is a train we could join on which we would continue to work hard to solve challenges around reducing process and improving equity, expand the availability of direct payments and make sure managed personal budgets offer authentic choice and control. The end of the journey won't be Nirvana but it will lead to many better lives than standing on the platform. We don't yet have all the answers but we can find them with a will.

I fear though that we are currently getting on another train. The recent ADASS survey showed that direct payment growth has stalled over the past year (so much for all these people being forced on to them) and all the personal budget increase has been in managed personal budgets. POET, other surveys and the now regular howls of anguish from commentators and bloggers point to extra bureaucracy and restrictions on budget use. On this train, in frustration, people start to wonder if this can be made to work - though no credible alternatives are put forward. The end of the journey for this train is not, in 2013 everyone making good use of personal budgets with most taking them as direct payments. It is 90% managed personal budgets which have not been developed to offer authentic control to their users. On this train people who should be supporting each other squabble about whose fault it is or whose responsibility it is to fix the train.

It isn't too late to change trains - let's get off this one at the next stop and all get on the right one together. What is the alternative?

6 comments for “Personal budgets - changing trains?”

Rob Greenland

posted 24 June 2011 at 14:49:46

Hello,

as you say the research has generated a lot of debate and interest. Can I be honest and say I'm not sure I follow what you're saying here - particularly your next to last paragraph.

Are you saying that we need to stop being so negative and come up with better alternatives? I'd certainly agree that if we just keep pointing to what's not working then we'll get nowhere - but I do think it's positive that people are starting to be a bit more honest about how things aren't working for a lot of people.

We're certainly working really hard on how to come up with better alternatives - with our Personalisation Made in Leeds network - and events like Crowdsourced Support Planning.
http://crowdsourcedsupportplanning.eventbrite.com/

We'd be keen to work with you and others more on this kind of thing.

Thanks

Rob
martin routledge

posted 24 June 2011 at 15:10:05

Thanks for the comment Rob - re the para you mention I agree we should look at what is not working and find solutions. There is such a lot to get right. There's a tricky balance to strike because there are many honest to goodness opponents of personalisation out there who will willfully misinterpret and use as sticks to beat it with. We are still far away from a situation where personalisation is mainstream culture or practice and we could go backwards in tough times. Your support planning ideas sound interesting - lets talk
Best
Martin
Vinesh Kumar

posted 24 June 2011 at 16:25:58

Hi Martin

Good post. With Direct Payments, (of course, there is choice in Direct Payments, but does it help the outcomes?)again there are two or more types of trains taken. One is there is abundant normal trains; the other second train is the outcome-focused train - even by taking my Personal Budget as a DP and then chosing a home care agency (or a PA)does not possibly help me to meet my outcomes. Most DP users use agencies and how many are outcome-focused? Something should be done locally and nationally about this. Empowering users to make informed decisions in how to use their DPs on what etc.

This has significance not only on Personal Budgets but say, a user regains functional skills through a reablement service, is that skill not lost by having this non-outcome focused long term home care provider whose support staff rushes in and out and (literally )throws the re-gained independence/skill through the window!

Thanks
vinesh
dee frost

posted 19 July 2011 at 16:07:38

I have used a PB from the end of IB pilot that I participated in, before this i was using the old style prescriptive direct payment. Being on a PB has changed my life!! Because I get a certain amount I am creative with this money make it go far further than my than the LAuthority ever did can set out my life employ my own staff live a life that is equal to others and has great quality.
The secret to success with a PB is having a good creative support plan. thinking outside the box about your whole life
Robin

posted 21 July 2011 at 13:06:59

I guess that on the one hand we've been waiting for this evidence that those people who were previously denied greater choice and control because they didn't want, or couldn't have, direct payments, were going to benefit from Self Directed Support. The evidence of this would be that the yearly rise in direct payments would slow down (because there was now another way of getting the degree of choice and control you wanted), and the number of personal budgets managed in other ways would increase quite sharply. So on the face of it, we can surely celebrate, as the Think Local Act Personal website does, that "More than 338,000 people are now managing their own support"...
On the other hand, I believe that what you are saying is that all may not be as it appears, and it may be more true to say, "More than 338,000 people are now described as having a 'personal budget', but that does not necessarily mean that they have all been given the required choice and control in determining the support they receive."
It is certainly true that over the last year people have reported: continued restrictions/delays in accessing or using direct payments alongside a reduction in the level of support available for people to do so; attempts to move people away from direct payments onto council-controlled mechanisms such as pre-payment cards; pressure to adopt 'in-house' solutions to needs, particularly through restrictions on support arrangements which are not made through direct payments (such as a limited menu of 'approved services'-which amounts to the continuation of the old system in a new guise!)...and more.
It is important that organisations such as in Control continue to highlight the mixed picture that lies behind the headlines, and I hope that you and others can encourage Think Local Act Personal to do the same!
Keep up the excellent work!
Martin

posted 23 July 2011 at 12:43:25

Thanks Robin. I know Think Local Act Personal plan soon to publish a number of materials relating to self-directed support including a stocktake of where we seem to have gotten to with personal budget delivery, key challenges and ways forward