What's next for personalisation? - blog from Care Minister, Norman Lamb

Personalisation is critical to the changes we need to see in our care and support system. At the centre of my vision for personalisation are two important principles, that we should build a system that promotes people's independence and wellbeing and that people should have control of their care and support and be able to make the choices that are right for them. Fundamentally, good care should mean care that is built around the whole person, their skills, aspirations and preferences as well as their needs. Good care should also extend the opportunity for independence and help to build stronger community links, not just for the few, but for everybody. This is why I have ensured that personalisation is at the heart of the Care Bill, the biggest change to the legal framework for care and support in England for more than 60 years. From the principle of wellbeing that underpins the reforms, to placing personal budgets on a statutory footing for people with support needs and carers for the first time, through to the new duties around information, advice, advocacy and market shaping - all of this is designed to set the context for making personalisation a reality.

This is why I called a Summit on personalisation in September, facilitated by Think Local Act Personal, to take stock of progress and redouble our efforts to get it right. I know that there has been some good progress. There are many more people receiving personal budgets now than when I came into office and the outcomes are reportedly better, and some places have made great strides in shifting the emphasis of care away from managing deficiency, towards prevention and enabling people to live better lives. But I also know that there is so much left to do. I hear about restrictive practices that limit choice, of people whose dignity is compromised in their own homes or in care homes because of poor care, of the limited progress that has been made with personalisation in mental health and of a cliff edge between care and health for people whose needs cross both. This has to change. We must refocus as the Care Bill approaches on making genuine personalisation the norm, in all settings and for all people, all of the time.

Another of my priorities is integration - person-centred, coordinated care - and I have personally seen to it that there is now a focus on making progress with this critical reform at pace and scale. Both through the announcement of the Pioneers in November and, along with my colleagues in government, provision for the Better Care Fund, which will help to redirect resources towards community based care and support and protect vital NHS services. But integration and personalisation are two sides of the same coin, it shouldn't be one or the other, and the current context presents a huge opportunity. By bringing our health and care systems closer together we can ensure that with integration, comes personalisation. So that people can expect the same focus on their independence, the same regard for their wishes and the same opportunities to make choices and to take control, whether they have a long term health condition or a social care need, a mental health problem or a learning disability. This is why I say that people themselves are the best integrators of their care. It is personalisation that will make this possible; including the use of personal health budgets, which I have ensured will be available with a "right to have" for everyone with NHS Continuing Care needs from October of this year.

In the midst of all this, there were some very clear messages from the personalisation summit about the things that need to happen to take personalisation forward. I am delighted that TLAP have led the work with partners published today, which provides a roadmap for personalisation in advance of the Bill. I will also write to councils about this and to bring several things in particular to their attention.

Firstly, to encourage them to sign up to Making it Real, TLAP's markers of progress, developed by people using care and support services, carers and family members, which set out what personalisation looks and feels like when it is working well in their own words. I have been impressed by the ways some councils, and many other organisations across the sector, have used Making it Real to build strong momentum for personalisation locally, and I want this to be a universal experience.

Secondly, The summit emphasised for me how important it is to focus on the outcomes from personal budgets, not just the numbers. Are people getting better lives and support and is the experience simpler and more flexible? This should be checked with people and families directly. One way of doing this is to use the Personal Budgets Outcomes Evaluation Tool (POET). I am really pleased to say that over the next year all councils who wish to use this tool will be able to do so and I would encourage all to do so.

But above and beyond this, I want to conclude by renewing my commitment today to supporting the sector to see this vital work through by contributing this blog as part of TLAP's work to create a new Partnership Agreement and by confirming Government's ongoing support for the Partnership as it moves into its next phase from April 2014.

Comments

Posted on by Les Scaife

Can the Partnership work on outlawing "Preferred Provider" policy by local authorities. They not only fly in the face of Personalisation,but councils also use them to side step Personalisation. Surely a list of all providers in the area would allow people to have complete freedom of choice. The bad providers would fall by the wayside and the only the good providers would survive
It's called market forces.

Posted on by Old Site User

Lightening the burden of this procurement led regime would also have a massive impact on reducing costs and bureaucracy for purchasers, and most significantly for providers who are already regulated by the CQC. This regime forces providers into costly tendering activity in each local authority in order to then participate in what should be a consumer led and competitive market. All participants in this procurement game, Winners, losers and commissioners, commit vast resources to this exercise; both sides of the exercise ultimately funded from the diminishing public purse.

Posted on by Old Site User

IN GREAT BRITAIN – AUTISM and LEARNING DISABILITY FUNDING

Sadly this is just another piece of window dressing following on from all the countless others before it.

What is happening in practice is that when all this window dressing passes down to Local Authorities the Local Authorities are able to break the law or bend it using Judicial Discretion and get away with have a telling off or pay a nominal compensation (only to those that are able to mount a challenge in the first place and stay the course) rather than pay out the larger funding amount that is required. This is done at the expense of the vulnerable, and carried out with the use of sanctimonious, convoluted meaningless jargon.

We are all sharing the same experiences. We are all saying the same thing- but separately. We are all banging our heads up against a brick wall becoming frustrated, bewildered, angry, despairing almost radicalised. Whichever way and however you approach “them” (Local Authorities/Social Services/Learning Disability Partnerships) you arrive at zero or stay at square one during which long drawn out time you are tortured and then punished with the fallout of the consequences that “they” have created.
We are all going to carry on stressfully struggling through the ever increasing labyrinth of jargon and formulations, and bureaucratic hoops and stages, at the mercy of those despicable people that are exercising their discretionary powers this way, only to come full circle and end up back where we started, and having to repeat the whole stressful meaningless exercise yet again. All the while having to deal with an incredibly stressful learning disability lifestyle. Legally and morally we still have to go through the whole charade to verify our case even though the result is injustice. The RAS forms are rigged (by a person) with a factoring quotation that always gives a zero result !
Sadly it seems by all our experiences that all our efforts at bringing into reality the humanity that we are lead to believe is what makes us humans different are being
crushed by the people with no humanity and who have the power to do it.

This problem is systemic.

This systemic problem is made possible by the policy that drives it.
The policy comes from the Government policy.
The Government policy comes from the Government manifesto.
The Government manifesto starts as the election manifesto.
The election manifesto containing the policies is presented to the public at the general election.
If the public want the policies they vote for them

It’s simple, the public voted to cut welfare benefits, a term they understood as unemployment benefits by the way that pre-election discussions where always spearheaded. However, there is also a simple agenda, the Government is using the vote catching "get the unemployed loafers off benefits" and be like the rest of the "hard working people" by using the word Welfare as a Trojan Horse to include and cut Disability, Learning Disability, and Autism support funding.

However, those hard working people are the same people that have sons, daughters, spouses, family members who are suffering disabilities and are struggling against this despicable agenda and the despicable people that are employed to carry this out in the name of "care". According to Mencap there are approximately 1.4 million people in UK affected by learning disabilities. Add to this all the “elderly hard working families” that have or are affected by a son, daughter or relative with autism or learning disabilities and you have got a sizeable chunk of angry voters.

So what’s the answer if you’re in my position. (It’s all happening on our watch)

The answer, in my opinion after a very long and stressful learning curve, is not to petition this Minister or that Minister, because they pass you from pillar to post and Parties will fudge and invent (expensive) commissioners, commissions or working committees that never conclude anything satisfactorily,

I think what we are all saying should be said together as one voice, I think the total number of voices are considerable and we should all sign up to this (no charge) .
We then agree a mandate list of requirements that must be carried out (now).
This could include funding, a dethroning of Local Authorities judicial discretion and clarification of social service legal limits making them a service proper. etc
This mandate would be presented to the main political parties prior to the next general election offering them the chance to pledge to include our demands into their policy in return for our vote.
If no party agrees we withhold our vote. If it is our moral duty to vote why would we vote for immoral representatives.

We all know that politicians are desperate for every last vote.

Richard Griffiths


Posted on by Paul Munim

There should also be emphasis on encouraging people to look around their communities and access services from voluntary and community sector organisations. Many people do not realise that the third sector exists and it provides services that are free but in each area it is a case of find out out is offering what services. We have created a website http://www.useyourcommunity.com which can enable people to find out who is offering what in their area by simply typing in their postcode. We need to promote our free website to more people because we believe not enough people know about their local services

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