Personalisation: What's Next?

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.

Many social care services have been transformed over the last ten years. Personal budgets, direct payments are a catalyst for changing lives. But unlike children who ask "have we arrived yet?" personalisation can be seen as a continuing journey, without a clear end point. Perhaps in the words of James T Kirk "to boldly go where no one has gone before" is more accurate.

I've been hearing a lot about Personal Budgets, what does this mean?

At a time of considerable change to professional roles and organisational structures, where concerns have been expressed about the lack of the distinctive part that social workers have played in the broader provision of health and social services for people with mental health problems; personalisation can and has provided a platform for change. Making personalisation work in mental health services matters because as professionals we know it is those with Mental Health problems that are the most likely to benefit from a personal budget, yet the least likely to get one.

There is much to celebrate in our 'Think Local - Act Personal' effort to embed personalisation into everything we do. Many and diverse stakeholders have come together to hold conversations which have led all of us to think outside our personal and organisational boxes. Together we have worked hard to put cultural and structural differences aside in the spirit of working together to find solutions.

The real motor for personalisation is not personal budgets but the recognition that social outcomes are not produced by services but coproduced through the actions of people and communities, aided or otherwise by services. Coproduction has always existed but has mostly not been acknowledged or explicitly supported. This applies as much to children, young people and families as it does to adults and older people.

Housing has a critical part to play in the personalisation agenda. Being able to live as independently as possible in where you call 'home' is a fundamental part of having meaningful choice and control. As TLAP considers what should be its top priorities for action over the coming years, Sitra would like to ensure the partnership actively engages housing providers and commissioners.

I sometimes think everyone who talks about personalisation should have the experience of working with deafblind people. It throws up healthy challenges to the way we work that have something to offer the debate around the future of personalisation. It can be a real test of your commitment to putting the person at the centre of what you do, of making no assumptions of what will and won't work, of listening to what is wanted (and what is not).

There has been a lot of change for local authorities over the past couple of years due to increasing demand and spending cuts of 43 per cent across the current Parliament, local government as a whole faces a funding gap of £15.6 billion by 2020. This has invariably impacted on adult social care where budgets have seen a cut of 20 per cent, equating to around £2.6 billion.

My involvement in what was to become the Think Local Act Personal (TLAP) partnership actually predates the initiative. My memory of the time is that providers felt that their views were not sufficiently acknowledged, particularly by commissioners, and that they were not trusted. To successfully bring about transformational change to care and support services all the key stakeholders would need to work together.

TLAP is busy taking stock of all that we've done over the past three years in preparation for refreshing the partnership agreement. It's an exciting time, and the National Co-Production Advisory Group is central to this process. In the words of Sam Bennett -Programme Director of TLAP, "NCAG is the beating heart of TLAP".

Health and social care integration is the current hot topic and comes with significant funding from government (£2.7b followed by 3100m in 2013/14 and then an extra £200m in 2014/15). If local authorities' use of personalisation implementation money in England is anything to go by - with the majority of the money being used to put resource allocation systems in place - then it is likely that most of the money allocated to support health and social care integration is likely to be used to fund top-down macro-structural change. Which may be missing the point...........

What we need to aim for is the development of safe, strong, self-supporting communities in which the days of simply ringing the council because a frail elderly person needs snow shifting or shopping done is a thing of the past. I think we'll also look back in horror at the way we've so often had to deliver social care responsibilities by bussing someone to a day centre miles away from home for the day, then returning the person to continued isolation afterwards.

Now feels like the right time to stop and check whether the vision spelt out in TLAP's original partnership agreement remains appropriate or whether it could benefit from a refresh