A life well lived is priceless

Head of TLAP Caroline Speirs gives a blunt reminder on the 'value' of personalisation.

Recently I was at a conference – virtual of course – and in one of the sessions someone asked the question, ‘does personalisation represent value for money?’

I have to confess I was shocked that in 2020, thirteen years after the publication of the Putting People First concordat, ten years after Think Local Act Personal was founded and six years after the Care Act became law, that this question was still being asked. Personalisation was not introduced to save money, it was established to offer a route out of life and limb/time and task service provision to enable a life more ordinary: that is to say, to offer ‘a life not a service’.

A blunt reminder

The question was instructive in serving as a blunt reminder that personalisation remains unfinished business. Providing the opportunities for people accessing care and support to exercise choice and control over their own lives still has a long way to go.

Pretty much everyone in the social care system agrees that it needs reform – whether that’s the way it’s funded, the lack of parity between care workers and health workers, the outdated modes of commissioning, the reliance on process over progress and so on. But underneath all those system-wide issues, lies the very real need to understand what people who rely on care and support think is really important – what matters to them in other words. Those are the things that you find out through co-production, through having good open conversations, through Making it Real. That’s where personalisation, and having access to different and innovative models of support in the community can make a real and genuine difference to people’s lives.

But we can’t ignore the question. Does personalisation offer value for money?  I think most of us would intuitively agree that a life well lived is priceless.  And it was always felt that the value of personalisation would come through delivering improved outcomes for people not through local authorities saving money.   Personal Outcomes Evaluation Tool (POET) studies have demonstrated that where people have control over how their support is provided and who provides it, there is a corollary with improved outcomes. The National Audit office noted that “giving users more choice and control over their care through personal budgets supported by well-designed local authority processes and a range of genuine choice within an effective and sustainable local care market, can improve their quality of life”. (There’s a very good reason for all those caveats.)

The economics of wellbeing

The economics of wellbeing more generally support the idea that savings will be made when outcomes are improved…a reduction in A&E visits, reduced visits to the GP, reduction in anxiety, depression, increased employment, etc.  Of course, the savings realised may end up in the pocket of a different part of the system.  And that’s where we have to wise up and acknowledge savings beyond our own bit of the system.

However, this is all a distraction.  Personalisation is supposed to be, first and foremost, life enhancing and we should not feel a need to monetise that. Perhaps instead of focusing on whether personalisation is value for money, the question should be is personalisation valuable?  Hundreds of thousands of people who are living their lives doing the things that matter most to them because of a personalised/human centred approach would answer with a resounding yes.

A different vision

Down the virtual road, a different but related conference was hosting sessions all based on a genuine vision for a social care future that dreams of ‘a place we call home with the people and things that we love, in communities where we look out for one another.” This is surely the stuff of life.

So when people ask me about TLAP’s role in today’s difficult environment, I think back to that question in the conference. I remind myself and them that we need to redouble our efforts to support a vision that enables individuals to find their own voices to sing out that everyone has the right to seek a better future.