P.O.E.T. 2013
Learning from the National Personal Budget Survey.
The uptake of personal budgets in
England (HSCIC)
Very large increase in number of people recorded as using self-directed support
Note forthcoming ADASS survey shows larger numbers using different definition
The uptake of personal budgets in
England (HSCIC)
Large majority of SDS and biggest increases over time in council-managed SDS
The uptake of personal budgets in
England (HSCIC)
Much more limited increase in people using direct payments
Large variations in SDS coverage
Across councils:
• Across England, on average 14.2 people per 1,000 are getting SDS
– 24 councils have more than 20 people per 1,000 getting SDS (max 34.6 per 1,000)
– 27 councils have less than 10 people per 1,000 getting SDS (min 4.6 per 1,000)
• In Council A you are 7.5 times more likely to get SDS than in Council B
• Across England, on average 2.3 people per 1,000 are getting a DP
– 33 councils provide DPs to more than 3 people per 1,000 (max 8.35 per 1,000)
– 33 councils provide DPs to less than 1.5 people per 1,000 (min 0, then 0.35 per 1,000)
• In Council X you are 24 times more likely to get a DP than in Council Y
Across groups – proportion of SDS users:
• Physical disabilities 13.7%; Mental health 4.2%; Learning disabilities
12.7%; Age 65-74 years 12.1%; 75-84 years 24.8%; 85+ years 31.8%
Note: ADASS survey suggests higher numbers but key is variation
The process experience for people
taking control of a personal budget
100
90
80
70
60
50
40
30
Best L.A.
20
Poorest L.A.
10
0
People reporting process as easy in the “best”
councils
The process experience for people
taking control of a personal budget
100
90
80
70
60
50
40
30
Best L.A.
20
Poorest L.A.
10
0
People reporting process as easy
The process experience varied considerably across Local Authorities
The outcomes for people taking control
of a personal budget
100
90
80
70
60
50
40
30
Best L.A.
20
Worst L.A.
10
0
Outcomes for people with a personal budget
The outcomes for people taking control
of a personal budget
100
90
80
70
60
50
40
30
Best L.A.
20
Worst L.A.
10
0
Outcomes for people with a personal budget
Outcomes for people varied considerably across Local Authorities
The impact of personal budgets on lives
of carers
100
90
80
70
60
50
40
30
20
10
0
Outcomes for carers
The process conditions associated with
better outcomes
4
3
2
1
0
Principles for delivery emerging from our
understanding of what works
To be counted as a personal budget the person who needs support should
know how much money they have for their support and be able to use the money
in ways and at times that make sense to them.
• User friendly
Getting, controlling and accounting for a personal budget must be simple and straightforward
for everyone involved including social workers, providers, people who need support and
their families.
• Transparency
People must know how much money they have in their personal budget and how they can
use that money.
• Control
Having determined eligibility and allocation of funds, local authorities must relinquish control as far as possible
and encourage people who need support to determine their own solutions to their own needs.
• Engagement
People taking control of a personal budget and their families will very often need help and
support to plan and make decisions. This support should be free from the tensions of rationing.
Challenges and opportunities
Challenges:
1. There are big variations: places, groups, DP/managed personal budgets.
Some places offering much better process and outcomes than others.
Where poor process, low DPs etc. how much choice and control?
2. Personal budgets can significantly improve lives and we are getting
increasingly clear about what leads to the best results but many councils
are not self-aware on PBs and best practice is not common enough
Opportunities:
1. Bill regulations, guidance and implementation can lever authentic selfdirection using what is known leads to best results
2. ADASS/LGA, TEASC, TLAP and others can support self-awareness and
build stronger links between NPBS findings, best practice and
approaches, advice to councils, support to outliers, peer support,
improvement activity