The White Paper: In conversation with the National Co-production Advisory Group

"You can't help feeling encouraged by the intentions but I need to know what this means in reality for me":

A conversation with Sally Percival and Clenton Farquharson from the National Co-production Advisory Group

The 'Caring for our future: reforming care and support' White Paper was published in mid-July, so over the summer, Shahana Ramsden, caught up with Sally Percival and Clenton Farquharson to hear about their first impressions.

Shahana - Did you manage to wade through all 65 pages of the White Paper?

Clenton - Yes, I got there in the end. It was a long document which is why I wanted to use time over the summer to read through it. My first impressions are that there are some positive messages in the document, but we need more detail. The paper also provides us with further opportunities to influence as it is not yet set in stone.

Sally - Same here, I read the document more than once to take it all in - my copy is now covered in post it notes and falling apart slightly. I started by looking up a description of what a White Paper is. The definition describes it as:

"An authoritative guide or report that helps solve problems and may be used as a consultation as to the details of new legislation" On that basis it actually does what it says -talks about problems and the potential solutions

Clenton - It reminded me of Lewis Carroll's Through the Looking Glass. Alice went through the mirror and it was all back-to-front. I was reading, thinking that I feel I have entered the looking glass world. What I am reading is very different from the real world - it gives us hope, but the devil is in the detail and I don't see enough detail.

Shahana - Great comparison, Clenton. If we took the metaphor further I would be asking you which part of the White Paper reminds you of the Mad Hatter's tea party! But on a more serious note, what were you pleased or concerned about when you first read the document?

Sally - I liked the fact that the document is reader friendly. It is clearly echoing the style of the Making it Real statements, so for someone who is familiar with Making it Real the style felt familiar. I was also pleased to finally see a government document talking about "people who use services and carers" rather than just "users" or "patients". Unfortunately, towards the end they slipped into "service user" again, which was a shame!

Clenton - Of course, I was pleased that the White Paper's five outcome statements are very closely aligned with the Making it Real statements, but it was a missed opportunity that the link was not explicitly mentioned. However it was great that Think Local Act Personal (TLAP) role is highlighted a number of times. Also, the importance of co-production and consultation - from our perspective - it is a real boost for us. It was great to see this!

Sally - Throughout the document, I was interested to see how different areas would work out. I kept asking, "What will local authorities do about this in reality?". For example, encouraging people living in residential care to go to work, and a proposal that their earnings from the employment will be exempt from residential care charges. I wondered what links would be made with access to work funding - how is the jigsaw going to come together?

Also, I welcomed the proposal for 'Portability' - people are trapped into not being able to move areas due to the risk of losing their support. For a family like mine, I have children that are moving away. It would be lovely to think that we might move closer to them, but this will involve settling down and adjustment for my son. The White Paper suggests that a care package would be portable and that there would be a re-assessment after a period of time. Coucils would need to provide written reasons if the re-assessment is different from the existing support package. If this comes into force it would certainly be helpful to me families like mine.

One more relief is that people were worried about Fair Access to Care (FAC) criteria. In one local authority the reduction of FACs caused lots of problems. The paper proposes that there should be no need to tighten the criteria for FACs. This is a relief, because as a family we won't have to worry that the support that we rely on so heavy might be taken away. It is great to have this written in black and white.

For me, carers represent best value in the support stakes. The White Paper will legislate to extend a right to the carers' assessment to provide an entitlement to a personal budget. I personally asked for a carer's personal budget and was turned down. So again, we have to ask ll be in place to translate these changes into reality.

Equally, there is a lot of talk about social work leaders and leadership focused programmes. I think self-advocacy and leadership training for people using the service should be much more clearly emphasised with links to Partners in Policy-type training for people using services and carers.

Clenton - As Making it Real mentions, there has to be a real shift in the culture of social care. Social care staff have got to truly believe this is the right way to go. I still hear that health and social care staff don't believe personal budgets are the right way to go.

I welcomed the focus on better information and advice, but the solutions are online or web-based. This is great for younger people coming on board, but what about people who don't have online access or who are not confident with computers?

I was pleased to see the acknowledgement of the link between housing and care. The proposed £200 million funding sounds fantastic, but when it is spread across the whole country, will it be enough?

Sally - it is certainly a double-edged sword. My personal worry is that when there is funding this is used for new institutions being built. In the Barrow area - a purpose built block for older people with 20 beds - is being used for people with a learning disability. Locally, people are being told that they will not be funded for individual housing - and that it needs to be in a block of six. It is important that housing solutions are used to enhance, not hamper people's lives. We want to have choice over where we live and have choice over who we live with. There is certainly a risk that the £200 million could be used to build mini-institutions.

Shahana - Finally, do you think that the White Paper proposals will make a difference to your lives? Do they give you hope?

Sally - One good thing about the White Paper is that working together with people who use services is mentioned. That opens doors for us to continue to influence the detail. We have to be hopeful or change doesn't happen. As people who use services and carers, we can use this as a lever and point out that it states this or that in the Paper.

Clenton - Does it give me hope for a better life? You can't help feeling encouraged by the intentions, but I need to know what this means in reality for me in Birmingham? What will my council do differently? What will the day-to-day detail of this look like when I wake up every morning. I have to admit that I am worried that momentum will lost. There are a lot of good ideas, but not enough funding to make this a reality.

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