Personalisation: The Wider Context
Martin Routledge – Department of Health
• 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 Budgets
30% of people receive personal budgets SDS is mainstreamed;
simple and streamlined customer journey
• Prevention and cost effective services
Reablement /enablement; people supported into work; high use
of telecare; timebanking; peer support
• Information and advice
Independent 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 practice
from 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:
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• 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 selfassessment”.
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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.
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