Dr Joshua Pritchard is a Researcher at Reform, an independent, non-party, public services think tank that focuses on achieving better public services and delivering value-for-money in the UK. He recently co-authored a report on personal budgets in public services.
When the NHS recently announced their plans to roll-out personal health budgets to 200,000 people by 2025, it became clear that the large-scale use of personal budgets would no longer be confined to social care. Coupled with pilot schemes in maternity care, rehabilitation, and unemployment, this drive for personalised public services could see almost a million personal budgets in use across England by 2025.
The scale of this expansion means there is an urgent need to understand how to make personal budgets (i.e. the ring-fenced allocation of money from a government body or local authority to help an individual meet their assessed needs) work for everyone – not just recipients of personal budgets, but the staff and providers tasked with supporting them.
The latest report by Reform think tank aims to achieve this. Drawing upon the experiences of the 500,000 people with long-term social care needs who already benefit from a personal budget, the report highlights several key areas that are crucial to get right for personal budgets to be successful.
One such issue is ensuring that personal budget holders receive adequate information to effectively purchase their own services. Research by the National Audit Office found that a failure to provide this could lead to worse outcomes for service users or poor value-for-money. A survey by Think Local Act Personal similarly revealed that only half of adult social care personal budget holders said their local authority had made it “easy” to get the right information to choose and purchase their care and support.
Solving this problem requires a two-pronged approach.
First, there need to be improvements in the digital information made available to personal budget holders about what services and goods are available in their local areas, particularly given the “digital by default” approach of many local authorities. The implementation of a “digital standard” for local service directories would be an effective way of guaranteeing a minimum quality across different local authorities and reducing the “postcode-lottery” of information for citizens. The £7 million Local Digital Fund has already begun to support local councils in sharing expertise and improving the digital services they offer, including around local service directories. More local authorities should engage with shared improvement schemes to ensure that no areas and citizens are left-behind.
However, whilst online information could assist many personal budget holders, it is not a perfect solution. Many individuals can be “digitally excluded” due to poverty, age, or disability.
Frontline and administrative staff must therefore be upskilled to better understand their obligations regarding personal budgets in social care. Yet evidence from previous schemes suggests that staff can struggle to gain or pass on information, due either to inexperience or being overworked. A decade of austerity has further reduced the amount of time available for social care workers to undertake additional training.
By making them available online, the accessibility of existing training schemes for staff could be greatly improved, such as the one-day course offered by the Social Care Institute of Excellence. There also needs to be a greater engagement with peer-to-peer advocacy groups such as Independent Living Advisors who can share their knowledge with personal budget holders at no additional cost to the individual.
Whilst personal budgets may improve outcomes for citizens, it is crucial that we learn the lessons from their use in social care before rolling them out into new areas of public services. Ensuring that personal budget holders are properly supported increases the chances of them receiving more effective and better value services, but only if they are given the information necessary to make informed decisions.