PERSONALISATION
Personalisation
Challenges and opportunities for
supported employment
Kathy Melling and Paul Wilson
Introduction
Our six themes for today:
1. What do we mean by personalisation?
2. The personalisation journey in UK
3. The challenges for service users, providers and commissioners
of supported employment
4. How BASE has been responding to those challenges?
5. What we`ve learned - BASE`s current position
6. The key issues for Irish stakeholders in the context of New
Directions
Personalisation means thinking about public
services and social care in an entirely
different way – starting with the person
rather than the service. It will require
transformation of the way we deliver public
services.
Julie Jones, Chief Executive, SCIE
Personalisation
Where did the idea come from
• Social work values
• Government agenda of choice and control
• Disabled people peoples’ movements
What is personalisation?
• Begins with the person, not the service
• Recognises a person’s strengths, preferences, networks
or support, friendship etc.
• The individual is best place to make decisions about
their life
• Access to information and advice
• Irrespective of whether self-funded or publicly funded
• About giving people choice and control over their lives
• Making sure that individuals live life as they want
What personalisation is not
• A completely new idea
• Just about giving people individual budgets
• Only for people eligible for Government funding or those
needing traditional services only
What it does mean
• Finding new collaborative ways of working and developing
local partnerships, which produce a range of services for
people to choose from and opportunities for social inclusion
• Tailoring support to people’s individual needs
• Recognising and supporting carers in their role, while
enabling them to maintain a life beyond their caring
responsibilities
• Access to universal community services and resources – a
total system response
• Early intervention and prevention so that people are
supported early on an in a way that’s right for them
Personalisation – 4 elements
Community facilities and
services that we all use,
e.g. transport, leisure,
health, education,
housing and access to
information and
advice
People as participants in
their communities,
friendships and family
relationships - individuals
with lives and relationships
Support that’s
available for people
to stay independent
for as long as
possible
People choosing who
provides their support
and what form that
support takes, and
controlling when and
where those services
are provided, rather
than being expected
to fit in with what’s
already on offer
What’s it all about?
The process by which state provided
services can be adapted to suit you
Personalisation
Self directed support
Individual
budgets
Personal
budgets
Support that is determined and
controlled by you, based on an
assessment of need by the state.
(Includes receiving cash, spending
on services that meet your needs, to
choosing which hospital you wish to
attend)
Like an IB but solely
made up of social
care funding
Direct
payments
An indicative amount of money
that can combine several
funding sources that you can
use to purchase services, from
the public, private or voluntary
sector
A cash payment paid directly to you so you can
acquire your own services, rather than having them
delivered by the council
Personalisation journey in the UK
Key themes:
• Clear policy intent across Government, but intent is only
benefitting some people
• Concentration of activity has been on PBs and RAS
methodology
• Inadequate attention to other system changes
• Inability to “braid” funding
• Varied life and satisfaction outcomes across service-user
groups
• Employment often not considered during assessment
• Impact of austerity measures
Personalisation journey in the UK
• In Control
• Think Local Act Personal (TLAP)
• Department of Health – Direct Payments, Jobs First,
personal health budgets
• Office for Disability Issues – Right to Control
• Liz Sayce review of specialist disability programmes
• Department of Education – Special Educational Needs
and Disability reforms
• How personalisation is being interpreted locally
The challenges to providers & service users
Good supported employment is:
• A genuine partnership
• Independence, choice and control
• The six stage process
Personal budgets mean:
• No change for customers
• Significant change for providers &
commissioners
The challenges to providers & service users
The three challenges posed by the marketplace:
1. Pricing challenges
2. Marketing challenges
3. Delivery challenges
The challenges to providers & service users
1. Pricing Challenges
• What do commissioners want to buy and how do
they want to buy it?
• The challenge of the hourly rate
• ‘Working hard’ to find ‘the right job’
• The service user`s `end to end` journey
• Predicting progress
• Fire-fighting
The challenges to providers & service users
2. Marketing challenges
• Selling directly to customers
• Differentiation (M&S or Poundshop)
• Price differentials
• Selling more than job starts
The challenges to providers & service users
3a.
Delivery challenges
The context:
• A professionalising sector
• Inspection, QI, payment by results
• The art of balancing risk, independence,
learning & progression
The challenges to providers & service users
3b.
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Delivery challenges
A retail model
Managing fluctuation in cases
Managing work flow & overcapacity
Economies of scale
The risks and rewards of an agency model
How BASE is responding to the agenda
• Discussion workshops for members
• BILD guide – Personalisation and Supported
Employment
• Mapping through member intelligence
• Engagement with Think Local Act Personal
(TLAP)
• Right to Control in Stockport – My job, My choice
• Work with SUSE
• Support to members
The challenges for commissioners
The need to work proactively with commissioners
Capacity-building work with the Scottish Union of
Supported Employment (SUSE) …..
The challenges for commissioners
The Commissioning Matrix developed for SUSE
The consultation and research suggest that the options for
commissioners revolve around two central themes:
1.Control: the extent to which a local authority intends to
manage the marketplace in which supported employment is
traded;
2.Pricing: the way the market defines and prices the
supported employment service which is traded in that
marketplace.
The challenges for commissioners
The Control Axis
The control axis describes to what extent the commissioner
intends to manage the marketplace.
At one end of this continuum is a free market.
At the other end of the continuum is the block contract
Somewhere near the middle is the Preferred Provider
scheme.
The challenges for commissioners
The Pricing Axis
The pricing axis describes how a local authority defines
what is being bought and sold.
At one end of the continuum is payment by occupancy.
At the other end of the continuum is payment by results.
Along the continuum are the degrees to which what is
being purchased is defined by milestones.
The challenges for commissioners
The Key Questions Framework
1. What presumption of employability do we hold for
service users?
2. What are our strategic considerations?
3. What is our approach to choice?
4. How do we want to manage or influence
performance?
5. How, if at all, do we want to influence quality?
Draft position statement on personalisation and
personal budgets
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Fully support the move to personalisation
Supported employment has always been a fully personalised model of employment
support
Not simply about giving people a personal budget
Professionalisation of the sector is at risk in a wholly individualised retail model
Need a different approach to how it is applied to employment support
Either an up-front fee to get a job, and lower fee for on-going support – a one-off
process or transaction that delivers longer term savings; or a strategic approach to
commissioning the service.
There is a need for commissioners to understand what evidence-based best practice
is to get those furthest away from the labour market jobs.
There is a need for disabled people to understand what good employment support
looks like if they are using their personal budget to purchase employment support.
There is a need for an evidence-base of the genuine costs to deliver supported
employment using personal budgets.
There will always be infra-structure costs as not all activities of supported
employment can be attributed to one particular person using a service. There is a
need for an evidence-base of the percentages of what that this will be.
Key issues for Irish stakeholders
• Personal budgets do not guarantee
personalisation
• Personal budgets need to be powerful enough to
achieve multi-service integration
• Understand the barriers to achieving
personalisation through New Directions
• Collective purchasing & Value for Money issues
• Supported employment infrastructure costs
• Transition arrangements
Summary
Our six themes covered today:
1. What do we mean by personalisation?
2. The personalisation journey in UK
3. The challenges for service users, providers and commissioners
of supported employment
4. How BASE has been responding to those challenges?
5. What we`ve learned - BASE`s current position
6. The key issues for Irish stakeholders in the context of New
Directions
Personalisation & Supported Employment
Questions & discussion points