Martin Routledge – Department of Health

Personalisation: The Wider Context

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• Putting People First policy of the last government set the policy direction for Adult Social Care for 2008-2011

• ADASS/LGA Milestones introduced in Sept 09 explain progress expected by 2011

• Full transformation will take longer

• No council has yet completely “got it right”

• But there are many emerging examples of good practice

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How did we get here?

• Inclusion and Independent Living Movements

• CILs

• Direct Payments Legislation 1996

• Policy evolving in direction of personalisation over recent years

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Policy Context

• We understand the urgency of reforming the system of social care to provide much more control to individuals and their carers

• We will extend the greater roll-out of personal budgets to give people and their carers more control and purchasing power.

Coalition Programme for Government

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Key Milestones Sept 09 - March 2011

• Effective partnerships Healthy ULOs; development of citizen leaders; co-leadership

• SDS and Personal Budgets30% of people receive personal budgets SDS is mainstreamed; simple and streamlined customer journey

• Prevention and cost effective servicesReablement /enablement; people supported into work; high use of telecare; timebanking; peer support

• Information and adviceIndependent advice to all inc self funders; use of web and other technologies to provide simple and easily accessible advice

• Local Commissioning Outcome based contracting; more flexible services, increase in DPs

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What’s around the corner?

• New Vision for Social Care will set out Coalition policy on adult social care

• White Paper will follow in 2011 incorporating proposals from the Law Commission and the Independent Commission on the Funding of Care and Support

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What’s around the corner?

New proposed sector partnership agreement published November 4th

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This agreement draws on learning from implementing Putting People First across England over the past three years and focuses on areas where further action is required. The agreement:

• Underlines the necessary connection between preventative, community-based approaches and personalised care and support.

• Provides a general framework for action supported in the next few months by examples to assist partners in benchmarking progress, and by co-designed tools to aid delivery.

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• “Personalisation and community are the key building blocks of a reform agenda, shaped around an individual’s own expertise and resources. When people need ongoing support, this should help them to retain or regain the benefits of community membership including living in their own homes, maintaining or gaining employment and making a positive contribution to the communities they live in.

• Experience has shown that most progress in implementing personalisation is made

where:

Local leadership focuses on cultural change, just as much as systems change, encouraging concentration on outcomes determined by people and communities and engaging solutions beyond the narrow definitions of social care.

People have real control over the resources used to secure care and support, with commissioning strongly guided by their decisions”

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“To help deliver the next steps in this agenda, the sector will develop a new set of benchmarks so local partners can check progress. There will also be a supportive tool providing links to a range of materials to aid delivery, based on the best practicefrom implementation to date. Councils and their partners can use these benchmarks with effect from 1 April 2011.…a new sector-wide partnership (will) offer national leadership and support on delivery of social care reform. This will include:

• Sharing learning and best practice and supporting problem solving.• Working with the Department of Health to support appropriate policy development.• Continuing the surveys of progress based on local self-assessment”.

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A series of products developed to support implementation activity linked to the new social care vision are planned including products on:

– Building community capacity

– Checking the results for people using personal budgets

– Market shaping

– Co-production

– Safeguarding and personalisation

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What’s in it for me?

• Evidence suggests strong leadership at senior level and frontline manager level is critical to success

• Opportunity to be involved in a major social reform

• Speaks to core social work values of empowerment and supporting people to improve their lives

• Outcomes based working enables self aware and responsive interventions to evolve over time and introduces an empirical foundation to drive practice

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Opportunities or threats?

• Financial environment

• Expect people to be active participants in designing and delivering their own solutions

• The need for clearer business cases for commissioned services

• Rising expectations from service users and carers

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The value of co-production

“The vision of personalisation can only be realised by empowering people who use services, their carers and families to play a leading role in shaping and driving the changes they want to see…Working together for change is a simple process for putting people who use services at the heart of commissioning…”

Working together for change, DH 2009

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….this Coalition Government is committed to personal budgets. Committed because in so many ways,

personal budgets encapsulate what we represent.

Our single, radical, aim - To change the relationship between the citizen and the state. To do less to people, and more with them. And to ensure Government steps back, making the space for people to lead the lives they want, how they want to.

In health and social care, that means giving people real choice over their treatment; real control over how money is spent; and real power to hold local services to account

Paul Burstow: Minister for Care Services July 2010

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Some views from the TASC Co-production group

How can we ensure that personalisation is meaningful and real?

• Use peoples positive stories about the difference personalisation has made to their lives and ensure that social care managers have the opportunity to listen to these accounts

• One key challenge to personalisation lies in the variable quality of information, advice, advocacy and brokerage if required. (for) a re-focussing on independent living and choice and control, it is vital that users are properly advised and supported

• ..must ensure that users and carers fully understand that they have options, eg not to personally manage a personal budget if they do not wish to do so; to have assistance in so doing (eg from a ULO or CIL) and that they can still purchase services from the local authority if they wish to do so

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• The safeguarding of recent developments in ULOs, CILs and Carers Centres is vital to providing information and support.The current investment in ULOs has ended but investment in their continued and developing roles is key to the roll-out of personalisation programmes

• The market place for social care needs developing…service users and their families cannot make best use of a personal budget if they have nothing to buy!

• Commissioners will have to work very closely with both providers and service users to shape local demand so that new services develop and existing services adapt to meet individual needs in a more person - centred way

• It is no longer acceptable for service users to be told what they can have … For this to become a reality it needs a massive shift in culture for staff of Health & Social Care design, commissioning and provision. The current ‘Them & Us’

attitude must first be breached so that true integrated working can take place.