When the government and social care sector published Putting People First in 2007, it felt hopeful and different. We had seen how direct payments were increasingly pushing more choice and flexibility towards users of social care services and this new ‘personalisation’ agenda explained in ‘Putting People First’ was going to extend direct payments to even more people. Individual budgets seemed both challenging but exciting, proposing new ways of working would present new challenges but also new opportunities in self-directed support.
Where are we four years after the publication of Putting People First? I’d say we are not much further along and certainly not where we should be. The same groups of people who benefited predominantly from direct payments are still benefiting. Systems have improved, but the lack of access to direct payments for people with mental health needs or for older adults (particularly those without family support) remains the case because the focus for the move towards individual budgets remains on those people who piloted the schemes.
So where now? The resource allocation systems have been a particular challenge, especially in the face of higher eligibility criteria and attempts to attach values and costs to specific needs. Wherever personalisation in mental health (and beyond) does go, what seems to be the most important is to look at broader ways to approach it beyond the ‘direct payments’ or ‘managed budget’ dichotomy.
As for the role of social work? There’s no doubting that social workers will remain at the forefront but will it be as gatekeepers or support planners? How will their know-how be used? Perhaps that’s one of the unanswered questions. I can’t help thinking that a move back towards an advice role would be welcomed, but my pessimistic side says that where there is a duty to provide care or support, there will always have to be a gatekeeper.
I’d love to hear about the roles that other people have had or play in the rolling out of the personalisation agenda and whether practice and the experiences of service users have changed on other areas, but more importantly what social workers can be focusing on and doing better.
Ermintrude
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