New thinking around public services using 'Systems Leadership'
Although it's far from being the whole story around Personalisation, having support of your own care funding, either through a personal budget or a direct payment, goes a long way in enabling people to exercise meaningful choice and control over their support. However, the level of that funding, and its usefulness in practical terms, are coming under ever-greater pressure.
On the one hand, local government are reporting higher numbers of personal budgets than ever before. In September, ADASS announced in their annual personal budgets survey that 76% of eligible adults received a personal budget in 2012-13, up from 53% the previous year.
On the other hand, if the pot from which the personal budget is taken is steadily shrinking, it looks like some people using services no longer feel it's worth the effort. It's no coincidence that as councils have planned to take another £800m out of spending in 2012-13, with a significant proportion earmarking personal budgets as being under pressure, the number of people requesting direct payments has stalled.
Given that local authorities are facing further significant shortfalls in funding, the only way people using services are going to be able to exert any form of choice is if we all work differently. So I think that part of what's next for Personalisation should involve TLAP, at the very least, getting engaged with some of the new thinking going on around public services.
Some of this new thinking involves using 'Systems Leadership' approaches. This is to do with how you exert leadership when the problem you're facing is large and intractable; when you're not the only one in charge; when you need to really involve a lot of other people; and when you have no money.
Sound familiar? You start on the basis of a shared ambition, and the outcomes you want to get to. You make sure you harness ideas, energies, talent and expertise from a wide range of people - so you need to work on trust and solid relationships. And you acknowledge that you're working in a world of uncertainty, so it's all right to have partial solutions to problems - better to make some headway than none at all.
There are 22 pilot projects based around the country, looking at issues ranging from improving outcomes for older residents through a more integrated preventative approach; improving a local urgent care system using resident co-design and insight; improving mental health outcomes and services through developing better early identification and treatment options; and reducing gaps in health inequalities.
The pilots are already working with people using services, and Clenton Farquharson, TLAP Co-Chair, recently spoke at a Systems Leadership event in London, designed to get more people thinking about these new approaches. I hope we can get some real TLAP involvement in this development, as it could be a route to enabling real choice and control to be embedded despite the funding pressures.
 See ADASS (opens new window) Annual Surveys 2012 and 2013, and Improving Personal Budgets for Older People: A Review, by Martin Routledge and Sarah Carr (opens new window), TLAP/SCIE, January 2013