Report for Jip Executive: 19 January 2010

Paper C

REPORT FOR JIP EXECUTIVE: 19 JANUARY 2010

REGIONAL PROGRESS: IMPLEMENTATION OF PERSONAL BUDGETS

1PURPOSE OF REPORT

This report sets out the national view about progress milestones and support offered and an overview of regional progress. The JIP Executive is asked to support a joint DH and ADASS regional approach to help ensure delivery in the region of NI 130.

2BACKGROUND

DH has asked DRDs to prioritise implementation of personal budgets within their work plans for 2010/11 and identify a DH Social Care team lead to work with Martin Routledge and Martin Cattermole on understanding the position to date and supporting local authorities that are not as advanced in their transformation programmes.

PPF milestones

PPF milestones agreed with ADASS are:

By April 2010

That every council has introduced personal budgets, which are being used by existing or new service users/ carers

By October 2010

That all new service users / carers are offered a personal budget

That all service users whose care plans are subject to review are offered a personal budget

By March 2011

That 30% of eligible service users/carers have a personal budget

Central DH TASC team assessment of position

DH’s central assessment is that progress on milestones is behind in some Councils and more work is needed to speed up the pace on delivery for some areas. Only about 20 Councils across the country are issuing PBs to all new customers.

Work undertaken at the centre suggests that unless councils are issuing personal budgets to all new customers OR to all existing customers from the latest April 2010 they will not reach the March 2011 NI 130 target. Early work suggested that Councils needed to have started to issue PBs to all new customers by Oct 2009 in order for them to reach the target (as only a small number of new younger adults and about 20% of new older people to their lists each year - so new customers alone wont meet the target in one year).

DH requirement for Regional DH teams

DH has asked that the DRD Social Care identifies a lead within their DH regional team to link with the DH TASC central team and work with Councils that need support to achieve the target.

Following discussion with Ian Anderson the proposal is that the DH Regional team lead will be Sue Batty, who will link with Jan Clark to take forward this role. Sue will join Jan in meeting with Councils where possible and they will jointly agree actions going forward.

REGIONAL UPDATE & BARRIERS TO SUCCESS

An overview of regional progress is provided in the appendix. Up to now it is has been difficult for the JIP Personalisation Board to be confident about progress, as the Board has not been able to access trajectories and data on NI 130. The JIP Performance Group has now agreed to submit NI 130 data on a bi-monthly basis to support monitoring of this position and Jan Clark, Sue Batty and Judith Horsfall have already produced a template for gathering this information which is due to be considered by the JIP Performance Group.

Councils have reported more issues in relation to securing change for mental health service users. The JIP mental health and personalisation project has helped to raise the profile in Mental Health Trusts and some progress is being made in some areas. Lincolnshire and Northamptonshire are further ahead in terms of allocating personal budgets to service users with severe mental illness.

Trusts may be concerned about the risks to services that they currently provide and may also be concerned at the financial risks to them if they are managing community care purchasing budgets on behalf of Councils. Arrangements have been made to raise these issues with the MH Trust CEO group on 1 February 2010.

As Councils move to the full implementation of personal budgets and local government funding becomes increasingly constrained the traditional approaches taken to setting and balancing budgets need to be discarded and new approaches utilised. It is clear that for 2010/11 many Councils are still using the traditional approaches but this may be the last year where they will work. It is therefore proposed to hold a workshop for Directors/ADs and departmental and corporate finance leads to begin to define the processes that will be needed come Autumn 2010 and to learn from the experience of others to date. If JIP Exec Members feel that this would have value, then Ian Anderson has volunteered to organise and lead it with Jan Clark.

Recommendations

1. S Batty to work with J Clark to review existing local TASC plans and link with DH national team to offer support where needed
2. Performance Group to provide trajectories and bi-monthly update to JIP Personalisation Board on NI 130 data, broken down by service user group (see attached) (J Horsfall)
3. Paper on the key issues for MH and Personalisation to take to the 1 February 2010 MH Trust CEO meeting (S Batty & J Clark).
4. Organise a joint PCT, MH Trust and LA event to work on MH personalisation agenda across the NHS and social care (J Clark)
5. Finance and Commissioning workshop: Setting budgets and strategic commissioning plans to respond to personalisation. Aim for May/June 2010 (I Anderson and J Clark to organise)

Rachel Holynska & Ian Anderson

11.01.2010

Personal Budget information for ADASS Personalisation Network

7 January 2010

Authority
Derbyshire / 1 Nov 09 to 31 March 10 - test period with 1000 clients. 650 are existing, 350 are new.
From 1 April 10 – all new clients will be offered and existing clients at annual review stage
Not started to look at MH yet
DerbyCity / 1 Nov 09 to 31 March 10 – phase 1 with all OP and PD coming through reablement service and extending to some OP and PD at review
Doing a sample number of LD and MH at review stage
1 April 10 – if RAS is ok from phase 1 – will be offered to all new clients and existing at review
Leicestershire / Done a small pilot with 24 people
February to October 2010 larger pilot in North West of county – for all new referrals. Existing clients in this area will be looked at at annual review stage from May 2010.
If all is ok following pilot, will roll out across rest of County from October 2010
LeicesterCity / Existing clients are being transferred at annual review stage.
New clients being set up on personal budgets
Lincolnshire / Rolling out to all new clients from 11 January – training will be complete across the county by 15 March.
Existing clients will be offered at review stage from April 10.
Any existing client can change earlier if they ask
Northamptonshire / Staff training in Jan and Feb, after which all new clients will be offered a personal budget and all existing clients at review stage
Expecting a steep rise in Feb & March
Nottinghamshire / Currently working with small groups of existing clients – people on ILF, DP only, Talking Books. To look at clients getting low level home care next.
Do not currently have an agreed RAS, but working on having one in place by end of March.
No agreement yet on existing clients – but proposal out to do at annual review stage
NottinghamCity / Phase 1 roll out started in Nov 09 in 5 geographical areas with each area responsible for 1 client group. Working with all new and existing – at review – clients.
Phase 1 does not include MH – no agreed RAS yet
Will start to review Phase 1 in Feb, with aim of full roll out across City in April / May. Will only roll out if Phase 1 has been successful.
Hoping to include MH in Phase 2
Rutland / At April 2008 offered all new referrals a personal budgets
At April 2009 all existing clients were offered a personal budget at review
Is therefore now mainstream to all clients, including MH

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