From Grant Funding to Individual
Budgets: The Impact On Day
Services
Denyse Whillier
CEO Age Concern Ealing
The Context
• Day services are funded through a grant from
Ealing Council/ PCT towards the costs of
running services;
• The balance is made up from income generated
from charging for services and fundraising;
• 84% of the charity’s income comes from grants;
• The service is being re-commissioned from
October 2011 with the grant substantially cut;
• Because of recent funding cuts, the cost base
will be spread across fewer “business units.”
Underpinning Principles & Drivers
For Change At National Level
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Prevention
Personalisation
Partnership
Plurality
Protection
Productivity
People
About Our Day Services
• One service is run from 2 sheltered housing
units - capacity is restricted by room size;
• A second service is run in partnership with
Ealing Council through a community resource
centre that is intended to provide a diverse
range of services; costs are currently contained
through an SLA on rent, utilities etc;
• Both services operate to registration standards
following earlier reviews and the expectation that
they were to be regulated;
• Both services operate high quality case
management systems.
Current Challenges
• Actual attendances are some 30-40% less than
the number of allocated places;
• Income from charging can fluctuate significantly
which makes forecasting difficult;
• Marketing;
• Staff understanding that these services have to
operate in a business like manner if they are to
be financially sustainable;
• Ealing Council wants the voluntary sector to
develop services for those with ‘substantial’ and
‘critical’ needs.
The FACS Eligibility Criteria
• Day services meet the needs of people
from ‘low’ to ‘critical’ needs;
• Those we estimate have ‘substantial’ and
‘critical’ needs will require assessments by
Ealing Council;
• There is an overlap with Ealing Council
provision at one centre which could mean
we become competitors.
An Added Dimension
• Staff undertake comprehensive
assessment of needs and put together
case plans, similar to support plans – will
this be necessary going forward?
• If not, what will happen to the expertise
and reputation we’ve built up?
• ACE takes 3-6 social work students on
placement each year.
Personal Health Budgets
• A pilot involving around half the primary
care trusts in England is currently
underway, testing out personal health
budgets in the NHS.
• What impact will this have going forward?
Issues To Consider
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The financial risk is shunted to the provider because each service
is purchased individually, rather than on behalf of a group.
Services will have to manage take up through overbooking and
clear protocols around payment for example.
Costs have to be accurate and take into account non
attendances.
Barriers to non attendance e.g. expensive and inflexible transport
have to be addressed.
Local authorities set the benchmark for what they are prepared to
pay for services. However the price (and quality) of a service has
to be at a level that the person thinks is acceptable too or s/he will
make alternative arrangements.
More Issues…..
• The volume of administrative work will increase and
require resourcing.
• The infrastructure and systems have to be fit for
purpose.
• Given the level of financial risk, the charity cannot be
financially dependent on income from day services.
• The local authority has to work with the voluntary sector
to manage this change.
• The charity has to become the provider of choice.
• Marketing will increasingly become a key activity.
And Finally
• Is this a move back to lunch clubs?
Any Questions?