Individual Service
Funds
Colin Angel, Policy Director
United Kingdom Homecare
Association



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Member-led professional association
Represent 33% of UK’s independent and
voluntary sector homecare agencies
Promote high quality, sustainable care services so
that people can continue to live at home and in
their local community
Provide campaigning, leadership and support
@ukhca
@colintwangel
What is an Individual
Service Fund (ISF)?


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The management of a service users’ personal
budget to achieve agreed outcomes
Council pays budget directly to the provider
Provider arranges care according to the users’
wishes
@ukhca
@colintwangel
Individual Service Funds for
Homecare from In Control

Authors:
 Caroline Tomlinson (In Control)
 Michelle Livesley
(Helen Sanderson Associates)

Sponsors:
 UKHCA
 Mears Care Limited

Contributors:

People who use services

Wirral and Lancashire councils
Get the publication from In Control [Link]
@ukhca
@colintwangel
Where ISFs fit with
Government policy

White paper “Caring for our future”:
 Services close to home
 Greater choice and control

The Care Bill:
 Commissioning for wellbeing
 Personal budgets as an entitlement
 Direct payment as the preferred delivery method
@ukhca
@colintwangel
ISFs and degree of control
(for illustration purposes)
Council
commissioned
service
Council or
3rd party
managed
personal
budget
Less individual control
@ukhca
Direct
payment
to buy
services
Individual
Service
Fund
Direct
payment to
employ
personal
assistant(s)
More individual control
@colintwangel
Why is UKHCA supporting
ISFs?


Benefits for users, providers
and commissioners
Traditional purchase models
don’t make best use of
scarce resources
 Prescriptive planning
 Pressure on price & visit times
@ukhca
@colintwangel
The impact of current funding
on homecare visit duration
63%
10%
<= 15
minutes
@ukhca
16-30
minutes
11%
10%
31-45
minutes
46-60
minutes
Source: Angel, C (2012) Care is not a commodity
6%
Over 1
hour
@colintwangel
How and ISF works
(A simplified overview)
1. User receives personal budget allocation
from council to meet outcomes
2. User designs their support plan with the provider
3. Budget is paid to provider on a regular basis
 User can buy additional services, if desired
4. Provider delivers the service
 including buying services from elsewhere, if necessary
5. Provider able to account for how the budget is
spent in “near real time”
6. Council that desired outcomes are achieved
@ukhca
@colintwangel
The relationships within an
ISF
Service
user
1. Agreement & funds
Specifies compliance
requirements and obligations
Council
@ukhca
Provider
@colintwangel
The benefits for…
People who use services
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Can increase chance to remain at home
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Reduces implications for the individual of:
 Managing a direct payment
 Becoming the direct employer of a PA

Greater control over service
 Individual can prioritise what's most important for them
 Reduces "time and task” / inflexible commissioning
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Similar control as enjoyed by private purchasers
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Potential to be used by people who lack capacity
 With appropriate support and advocacy
@ukhca
@colintwangel
The benefits for…
Homecare providers

Offers greater flexibility:
 User and provider can negotiate care plan
to find ‘best fit’ between choice and resources
 Avoids prescriptive or inflexible plans, with unnecessary
authorisation procedures for minor changes
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Greater assurance of payment:
 Avoids credit control costs, reduces write-offs
 Better cash-flow, with predictable income
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Higher satisfaction for customers and staff
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Similar processes to private-purchase work
@ukhca
@colintwangel
The benefits for…
Local authority commissioners
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Can create a fast-track process to get people
onto personal budgets
Has the assurance that outcomes are defined
 Agrees the outcomes with the person using the service
 But leaves the detail how and when to the experts

Reduces contracting effort
 But savings need to be passed to providers, who take on
this role
@ukhca
@colintwangel
People with an ISF should be
able to say…
What?
“I can use my hours/budget flexibly and can
choose what I am supported with”
Where?
“I am supported where it makes sense for me;
at home and out and about”
Who?
“I choose who I want to support me. My
support workers know me and I know them”
When?
“I get support on the days and at the times
that are right for me”
How?
“I choose how I am supported and my support
workers know this is important to me”
Coproduction
“I am fully involved in decisions about my own
support and how the wider service develops”
@ukhca
@colintwangel
Some practical
considerations
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How the payment made?
 In advance or arrears?
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Is users’ contribution paid to council or provider?
 Provider-collection is higher risk, but may increase QA
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Need a system for dispute resolution
 Eg. missed visits, or user not at home when expected
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What is the price?
 Management costs different to high-volume contracts
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Develop experience in responsive plans
 Especially if not already supporting self-funders
@ukhca
@colintwangel
Making ISFs work in
practice
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ISFs need to be an available option to all
Willing providers must be identified and
able to deliver
Effective contracts need to be in place
 All parties must understand their responsibilities
 A specimen from Lancashire included in paper
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Monitoring to ensure that outcomes are achieved
 Reviews 6-weeks to check bedded-down, then annually,
or when needs change
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Trust is required between councils and providers
@ukhca
@colintwangel
How to contact me
Website:
www.ukhca.co.uk
E-mail:
colin.angel@ukhca.co.uk
Twitter:
@colintwangel
Telephone:
020 8661 8152
@ukhca
@colintwangel