Update on the National Picture of Personal Budgets and Direct Payments

Update on the National Picture of Personal Budgets and Direct Payments

Update on the national picture for Personal Budgets and Direct Payments.

This information is taken from ‘Community Care’ 30th March 2012.

Massive variations in personal budget take-up persist between councils and regions, the latest official figures show. While 29.2% of adult care users or carers receiving community services had a personal budget in 2010-11, up from 13% in 2009-10, rates ranged from 4% in Somerset to 71% in Manchester, according to statistics published by the NHS Information Centre.

The figures suggest progress on moving people on to personal budgets is slowest in the South West, where the average uptake is 18.3%, and fastest in the North West, at 35%.

The government has set a target of 100% uptake of personal budgets by April 2013 but the Association of Directors of Adult Social Services (ADASS) recently warned that the target could be counterproductive and could be driving authorities to implement budgets without ensuring they delivered genuine choice and control.

However, despite today's figures, ADASS vice-president Sarah Pickup said that "there is no reason to assume that we cannot meet the target of 100% by 2013 in most places".

"There are indeed significant variations," she said. "Some authorities got off to a slower start than others and some will have had some specific priorities to tackle."

Pickup added: "Personal budgets should always be the way in which we meet people's needs as a matter of course," she added. "If we are anywhere close to the 100% target then the strategic objective is surely achieved. If there are a few authorities that still have some work, that would not be seen as failure."

Extending personal budgets

There are also initiatives to test how personal budgets would benefit homeless clients and to people who misuse substances.

In England, personal health budgets are being tested to give people with mental health problems or long-term conditions control over resources spent on their healthcare. These are due to be rolled out from October 2012, though concerns have been raised by mental health professionals and service users over their potential to improve outcomes.

The personal budgets concept is also being extended into other government funding streams used by disabled people through the Right to Control initiative, which is being tested in seven areas.

This is designed to give disabled people control over resources for their social care, employment support, housing support and equipment and adaptations, to enable them to shape how the money is used.

How successful have direct payments and personal budgets been?

A number of studies have shown significant benefits for service users from personal budgets and direct payments:

  • The 2011 National Personal Budget Survey of 2,000 users and carers in England found that personal budgets were generally likely to have positive effects, with most users saying they had seen improvements in 10 out of 14 outcome areas from using personal budgets.
  • A 2010 report by charity In Control found that 68% of service users said that their lives had improved since they started using a personal budget.

The National Personal Budget Survey found that outcomes were better where service users were informed about the value of their personal budget, fully involved in the support planning process, alongside family carers, relatively free of constraints and bureaucracy, and where they had a direct payment rather than a council-managed personal budget.

However, the number of people using direct payments in England stalled from 2010-11, found the Association of Directors of Adult Social Services.

There are concerns that councils are looking to maintain control over resources by managing personal budgets themselves, rather than giving service users a direct payment. However, social workers have also raised concerns that some service users are not being given full freedom to choose a council-managed budget, as a result of some councils making direct payments their default option.

Bureaucracy and the implementation of personal budgets

Despite the links between less bureaucracy and positive outcomes for service users, the implementation of personal budgets has been beset by excessive bureaucracy.

Three-quarters of adult social workers said there was more bureaucracy in their role as a result of personalisation, found Community Care and Unison's annual 2011 survey on personalisation.

Explanations put forward for the increase in bureaucracy include councils having multiple assessment processes, combining legally required professionals assessments with supported self-assessments.

The situation has sparked repeated calls for the processes involved in personal budgets to be simplified.