Yesterday, I was planning to post a rather stroppy blog as I keep hearing tales of frustration and disillusionment as the personalisation agenda struggles to keep on the rails in the current financial climate. I hear stories of people on personal budgets who don’t even know they are on personal budgets. Presumably a tick-box type change of delivery has happened somewhere in the background. Oh yes, there was that N130 target of moving 30% of adult social care recipients on to personal budgets by the end of March…
I hear stories of personal budgets being cut so that people can no longer afford essential support, far less life-enhancing experiences. I hear of “service user engagement” groups disbanded and left feeling angry, having been feted as “key partners” for the last year or two. I hear providers who have invested heavily in training for personalisation feeling unsupported by Local Authorities who often now seem to be going (fairly blatantly, it seems) for the cheapest care available. One woman told me despairingly that she has always offered organic food to her residents in her small care home, but that costs are being squeezed so much that it is becoming totally unsustainable – all the more ironic as I am doing a project around the importance of good nutrition for frail, elderly people.
But that was yesterday’s blog. And, I never wrote it. Instead I had a wonderful day with Macmillan Cancer Care’s Learning and Development Managers, meeting in Bristol. What a brilliant organisation!
And, by today, things look brighter. The Think Local, Act Personal Partnership (TLAP), has been launched as a sector coalition to develop personalisation. This is timely as the last few weeks have felt like a bit of a vacuum. The Putting People First programme has technically ended… but people don’t always understand technicalities. There is a danger that people think the agenda itself has ended and this hiatus has fuelled the sense of confusion and frustration.
Anway, lots of things have happened today. The new TLAP website is up and running. There is a very sparky feature in Community Care, where it seems “Councils that fail to hit the mark face an unspecified form of intervention”. This appealed to me. Perhaps people who use services, in the true spirit of co-production, should vote on the penalties. The detail of the article mentioned a yellow card, as in football, but I think I prefer “Off with their heads!” in the style of Blackadder. After all, payment by results is catching on in the private sector.
There seems to some recognition of what is happening on the ground, the potential waste of investment and talent with the job far from finished. Community Care says there are “growing concerns that some councils are already reducing choice and control for users by making cuts to personal budgets or restricting what they can be spent on, while also cutting personalisation teams.” I have a lot of contacts in personalisation teams, generally very committed people with really valuable experience of getting personalisation up and (not yet fully) running. The number of “out of office – no longer employed – no such person – no such zone” type messages coming back over the last few months has been pretty grim, especially considering personalisation is such a government priority and so key to a sustainable future for health and social care.
We now need action more than further investigations and studies. I am cautiously optimistic that TLAP seems to have a healthy emphasis on action. I like the idea of whole sector engagement; I like the plan to involve people who use services and carers in judging progress. I like the feistiness of co-chair Miranda Wixon’s comment “If the government does ignore us it will be at its peril.” I welcome the wide membership and experience of the list of TLAP members – and am delighted to see Macmillan amongst them.
The communications role will be vital . A clear explanation is needed to convince people that personalisation and budgetary cuts are not one and the same, but also being realistic about the effects cuts DO have on choice and control. I feel this has been fudged up until now, which has done a great disservice to the principles of personalisation.
Another key task for the communications people is to stress continuity, to stress that this new programme is 100% building on Putting People First, rather than giving the impression a brand new initiative starting.
For me the “Think Local, Act Personal” tag is unfortunate and an unnecessary change. We should be doing EVERYTHING to get away from jargon in order to engage people fully, particularly to get the general public interested and on board, which I believe is one of the most significant failures to date. I much prefer the name “Putting People First” – who can argue with that? I like it because people (REAL people) can understand it without an explanatory booklet. But I guess with any change of government a new name is de rigueur! The content and the way things are carried forward will be the real test.
Anyway, I am a “glass half full” person and I look to the future with optimism. But I think people will be right to become impatient if there is not just a little bit more JFDI.
There are some excellent examples of good practice among all key players. Some local authorities have put really strong foundations in place – and so they should have done, given that they were given £520 million ring-fenced for transformation! Similarly, some providers are offering wonderful services promoting independence and choice, working with the wider community and with the person always in the centre.