Personalisation: no silver bullet

It’s been touted as the holy grail for giving full choice and control. But, says Professor Peter Beresford, beware of buzz words like “personalisation”

Like a lot of people I have long been worried about a policy that’s meant to transform support for older and disabled people, but which is framed in terms of jargon like “personalisation”.

Yet this policy is still being hyped by government, although now after three years and £1 billion for “transformation”, with the process not half achieved, government has offloaded responsibility and allowed just £1.2 million to complete the job. What does this bode for disabled people and other service users after all the claims made for personalisation and personal budgets, as eligibility criteria tighten and personal budget ceilings come down? 

We can get some idea from the findings of a survey of personal budget practitioners recently launched by the London Self-Directed Support Forum, which provides findings from front line workers. It draws on the experience of 40 workers from 19 different London authorities. While it is a small study, the independence and complexity of its findings paint a valuable if worrying picture.

Most practitioners report that they and service users don’t understand self-directed support. Most workers don’t think new systems of assessment ensure more choice and control and that people aren’t offered independent support to complete self assessment forms. Most don’t understand the “resource allocation system” – the RAS, which was meant to be personal budget’s unique selling point. In a majority of cases the RAS neither seems to be matching need or come closer to ensuring adequate financial resources. It has mostly tended to reduce people’s budgets.

In most settings, there are still restrictions on what people can purchase with their personal budget – which flies in the face of the essential point of moving to personal budgets. For a sizeable minority of people there still aren’t annual reviews and as for the Government’s demand that the system should be outcome based, an outcome based review process is still not in place for around half of cases.

Not all is doom and gloom however. In a number of cases we are seeing more creative support plans, a clear definition of a service brokerage scheme and support plans getting the go ahead. In about half of cases the brokerage service is rightly separate from support planning. In most cases there is ongoing support. But this is hardly the kind of transformation we were promised and it is clear that we are still far from the “transparent” and “de-bureaucratised” system of customized support that disabled people and other social care service users were promised. Perhaps most worrying, at least half the participants in this survey think that personalisation is a tick box exercise – which does not make for meaningful improvement. This survey clearly needs to be extended. But it offers government an early warning that it is probably going to have to go back to the drawing board if it is serious about “personalisation” and ”self-directed support” for all.