IPC
OUTCOMES WORKSHOP : DAY 1
National Drivers
Why Change our approach to outcomes ?
 People are living longer:
 180% increase in over 85s by 2036
 double number of people with dementia by 2036
 50% more people with LD between 2001-2021.
 Demographic change at its greatest in the Shires.
 Not much change in terms of incapacity in the final
years of life.
 Fewer available carers proportionately
 More diverse communities.
 Higher expectations of choice, dignity and respect.
 Prevention works, but common practice is resources
targeted at those with greatest need.
Reasons to change?
 Assessments tend to monitor a person at a particular
time rather than offering the flexibility that changing
demands, needs.
 Currently we focus too much on giving services in
the hope that they meet a need, rather than funding
to enable a set of outcomes.
Reasons to change?
 Because in times when money gets tight we should
only pay for what is needed and what will work. The
assessment needs also to focus on marshalling all of
peoples resources rather than just those the state
provides.
 Our current system focuses on eligibility for a
volume of service or amount of money based on
passing a set hurdles of incapacity rather than
emphasising the possibility of what can people do
and how can we continue to support that.
Independence, Wellbeing and Choice
 Quality of life, including leisure and social activities,
should be addressed for all service users (Chapter 3).
 Service users should have choice and control over
their services and manage risk in personal life
(Chapter 3).
 Services should become based on flexible, individual
care budgets to produce outcomes tailored to
individuals’ aspirations – extending to all service
users the advantages now enjoyed by Direct
Payments users (Chapter 4).
Our Health, Our Care, Our Say
 Improved health and emotional well-being
 Improved quality of life
 Making a positive contribution
 Increased choice and control
 Freedom from discrimination & harassment
 Economic well-being
 Maintaining personal dignity and respect
In Control seven characteristics of the support
plan
 Be person centred, ie about an individual and
recognisably so
 Set clear outcomes which are achievable and
measurable
 Describe the planned support which will lead to the
planned outcomes
 Keep the person healthy and safe
 Maximise self determination
 Show clear management, ie the plan should identify
who is responsible for what
 Be in budget
Personalisation and Transformation
2007 – Putting People First
Over time, people who use social care services and their
families will increasingly shape and commission their own
services. Personal budgets will ensure people receiving
public funding use available resources to choose their own
support services.
2008 – Transforming Social Care
“In the future, all individuals eligible for publicly-funded adult
social care will have a personal budget (other than in
circumstances where people require emergency access to
provision); a clear, upfront allocation of funding to enable
them to make informed choices about how best to meet their
needs, including their broader health and well-being.”
Personalisation means……
“that the individual is the basic building block of a social care
system. Need will be assessed by the individual, the desired
outcomes will be identified by the individual and the means to
determine how those outcomes will be met is controlled by
the individual”
Personalisation and Allied Health Professionals November 08
“The challenge will be to translate the vision into practical
change on the ground to make a real difference to the way
individuals engage with services and support and, in so
doing, make a real difference to their lives. It will also mean
changes in how professionals engage and work to support
people’s needs. Personalisation is about whole system
change, not about change at the margins”.
LAC Circular 1 (2008) Transforming Social Care, Department of Health January 2008
Enmeshing the personalisation agenda into
the outcomes approach
why worry personalisation, will resolve these issues’.
However:
 Some people may wish to continue with their current
arrangements because they are satisfied; or because
they do not want to make what might be perceived as
additional effort; or because they are too
incapacitated; do not see self directed care as an
option they can or would wish to pursue.
 In some more rural parts of the country, the problem
may not be offering a choice but getting any agency
or individual at an affordable price to deliver the
services needed.
Enmeshing the personalisation agenda into
the outcomes approach
 The need is to improve choice and control but
recognise this needs to go beyond purely fiscal
measures.
 To make sure resources are not being offered when
they are not needed and are offered in greater
abundance when they are or at a time when change
can be delivered which will divert people from more
intensive levels of provision.
Conclusions
Defining our national policy and strategic
commissioning in terms of outcomes is not enough
because:
 If we don’t define and purchase services in terms
of outcomes we will revert back to measuring and
monitoring results in terms of cost and volume.
 Because the relationships of needs to services
needs a third dynamic of what works.
 Volumes of service as proxy indicators do not
always work.
Choice, control and quality are all important but the
ultimate test is will this deliver the outcomes, the end
result I really need.