Choice has to feel easy
From my perspective and that of a provider interested in delivering better outcomes for people, personalisation needs to mean far more than just giving people money. We need people to have a real choice of good and tailored services to spend that money on.
There's no point in outsourcing decision making to people if they find it's just a new responsibility with none of the choice. So we need that genuine choice and market building. That has to be for everyone, not just for people who can speak up for themselves or those who have people around them who can help them speak up. We need choice for those who are least able to get their voices heard and in some areas advocacy is becoming worryingly scarce; choice processes have to feel easy.
People will settle for second best if achieving the services of their choice feels like wading through treacle. I think that means that the challenge for us, as providers, is that we don't go into this sector to construct support which just maintains people at survival level. We need to be moving towards the kind of support approaches which feel like they've got a future focus. In other words which don't just help people survive or cope with the challenge or problem they have today, but helping people to plan ahead and to start to move towards a better life tomorrow.
Understanding outcomes in that context is then a real challenge. We don't, as a sector, have a good culture of measuring outcomes. There is evidence out there, but we don't have that consistency yet around some of those most important outcomes, which have traditionally been seen as hardest to measure, and therefore hardest to buy and commission for.
We need to move from cheap to good. Actually, if we do that, we still won't be there, because you can have a great service, you could have a brilliantly tailored, well funded service, and still be living a miserable life. We can all think of people for who that's true, because they're still isolated. It's the older person who says, 'I feel useless, I don't feel like I've got a role, a place where I can contribute'. The person with a learning disability who's got great support during the day, but can't get a job. So if we're going to move from a good service to a good life, that's got to broaden out, and this is a huge challenge for TLAP.
We hear constantly from providers who say, 'I'm expected to be excellent, but the price the procurement department is willing to pay won't even pay minimum wage.' We're seeing areas where people are experiencing cuts in their individual resources, which don't feel like they're an individually decided process. So there are some huge challenges there.
So what does TLAP do about that? It's got to get those stuck areas unstuck, it's got to get behind the areas which are taking the risks and which are achieving. It's got to do that by putting people, and what people want, and the lives that people want to live, at the centre of that.
There's got to feel like there's a space for the "traditional" as well as the innovative. In other words, we've got to take some pretty huge risks, and we've got to do that at a time of, probably, unprecedented fear, and that's quite a big ask. The route to doing that is to get serious about co-production with people who use services, providers, commissioners and government.