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Article
Publication date: 2 August 2013

Vidhya Alakeson

The purpose of this paper is to illustrate the potential for service integration by focusing at the level of the individual rather than through structural integration or care…

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Abstract

Purpose

The purpose of this paper is to illustrate the potential for service integration by focusing at the level of the individual rather than through structural integration or care coordination. The paper illustrates the potential for integration through the experience of the personal health budgets pilot programme.

Design/methodology/approach

This paper is based on a review of the experience of personal health budget pilot sites, drawing on the national evaluation of the pilot programme and the author's experience of working with pilot sites between 2010 and 2013. It also draws on the experience of similar programmes in the USA.

Findings

Personal health budgets support integration in two distinct ways. First, they can support the delivery of more holistic, whole‐person care in line with the principles of shared decision making. Second, by bringing personal budgets in social care and personal health budgets together, they can provide a vehicle for integration across health and social care systems. If integration starts from, and responds to, what matters most to individuals rather than with the development of joint structures and processes, the result is more likely to be integrated care.

Originality/value

This is one of only a small number of papers that discusses the scope for personal health budgets to improve the integration of care. Integration between the NHS and social care, in particular, has been identified as a central priority for the NHS.

Details

Journal of Integrated Care, vol. 21 no. 4
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 April 2006

Simon Duffy

This article outlines the idea of an individual budget, which is now being promoted and tested by central government. It defines the idea, and describes the practical and policy…

Abstract

This article outlines the idea of an individual budget, which is now being promoted and tested by central government. It defines the idea, and describes the practical and policy consequences that may flow from its implementation. It also sets out some of the policy choices that will necessarily emerge from these developments. This article follows on from the earlier article in JIC (February 2005), which was the first article ever published on the subject.

Details

Journal of Integrated Care, vol. 14 no. 2
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 22 June 2009

Kate McAllister

Following the Communities and Local Government (CLG) pilot exercise, all sites remain committed to the concept of individual budgets. There are many positive stories of how…

107

Abstract

Following the Communities and Local Government (CLG) pilot exercise, all sites remain committed to the concept of individual budgets. There are many positive stories of how individual budgets (IBs) have made a real difference to people's lives, enabling true person‐centred support and informed choices about integrated packages of care and support. There were also impressive examples of creative joint working at site level, where sites adopted pragmatic solutions and worked round obstacles wherever possible. Based on experiences to date, all the pilot sites feel that IBs have a key role to play, but that they should not be considered as the only option for personalising housing‐ related support services and increasing choice. Commissioned Supporting People (SP) services can be responsive and person‐centred, as well as providing consistent coverage over large geographical areas, and some authorities consider that commissioned SP services can work alongside IBs and promoted this model as a viable alternative. More work is needed to understand better how IBs can work together with commissioned services to deliver a seamless service.

Details

Housing, Care and Support, vol. 12 no. 1
Type: Research Article
ISSN: 1460-8790

Keywords

Article
Publication date: 1 March 2010

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Abstract

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. 22 no. 3
Type: Research Article
ISSN: 1096-3367

Article
Publication date: 1 June 2008

Guy Daly, Annette Roebuck, Jennifer Dean, Fiona Goff, Martin Bollard and Clare Taylor

This article presents the findings of an evaluation of the impact on service users of a local authority's individual budgets pilot. The local authority has pursued an…

Abstract

This article presents the findings of an evaluation of the impact on service users of a local authority's individual budgets pilot. The local authority has pursued an outcomes‐focused approach to care planning. The research findings suggest that these service users and their families see individual budgets as a very positive development. Service users have been able to gain greater control over their lives, not least in that they are able to determine to a much greater extent how they have their needs met. This facilitates service users' general growth and development, such that they are able to engage more fully and on a more equal footing as part of their families and communities. However, there remain a number of challenges that need to be addressed if individual budgets, or personal budgets generally, are to be rolled out successfully across adult social and health care.

Details

Journal of Integrated Care, vol. 16 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 1 December 2008

Caroline Marsh

Individual budgets allow the service user to take control and make decisions about the care that they receive. Manchester was one of 13 local authority development sites chosen by…

Abstract

Individual budgets allow the service user to take control and make decisions about the care that they receive. Manchester was one of 13 local authority development sites chosen by the Department of Health to trial individual budgets. The pilot has ended but the scheme remains strong. Here, Caroline Marsh describes how one individual's life has been transformed through the power of choice.

Details

Working with Older People, vol. 12 no. 4
Type: Research Article
ISSN: 1366-3666

Article
Publication date: 11 May 2015

Jonathan Farrar, Theresa Libby and Linda Thorne

The purpose of this paper is to examine the effects of three different types of budget goals (egocentric individual, groupcentric individual and group) on group performance of an…

Abstract

Purpose

The purpose of this paper is to examine the effects of three different types of budget goals (egocentric individual, groupcentric individual and group) on group performance of an additive task, assigned within an individual budget-based incentive contract. While previous research has established that budget-based incentive contracts motivate higher group performance than piece rate contracts for additive group tasks, no studies, which we are aware of, have considered explicitly the type of goal within this context.

Design/methodology/approach

We conduct a 3 × 2 experiment in which we manipulate the presence of an individual goal (egocentric, groupcentric and absent) and a group goal (present and absent) on group performance of an additive task.

Findings

Group performance is higher for groups assigned groupcentric individual goals than for groups assigned egocentric individual goals, either alone or in combination with a group goal.

Practical implications

Egocentric individual goals may reinforce an individualistic orientation, which may work against the potential gains from having group members adopt more of a group focus.

Originality/value

This paper considers how groupcentric individual goals may improve group performance. The management accounting literature typically examines just egocentric individual goals.

Details

Review of Accounting and Finance, vol. 14 no. 2
Type: Research Article
ISSN: 1475-7702

Keywords

Article
Publication date: 17 June 2011

Sarah Carr

This paper aims to present a digest of the main discussion points and key findings from a recent Social Care Institute for Excellence report on risk enablement and safeguarding in…

5940

Abstract

Purpose

This paper aims to present a digest of the main discussion points and key findings from a recent Social Care Institute for Excellence report on risk enablement and safeguarding in the context of self‐directed support and personal budgets.

Design/methodology/approach

The paper explores how the personalisation agenda and adult safeguarding can work together in policy and practice and addresses some of the frontline concerns about empowerment and duty of care.

Findings

Evidence on how self‐directed support and personal budgets can be used to enable people to take positive risks while staying safe and emerging practice is examined. It suggests that person‐centred working in adult safeguarding, along with the mechanism of self‐directed support planning and outcome review, can support the individual to identify the risks they want to take and those they want to avoid in order to stay safe. It is clear that if frontline practitioners are overly occupied with protecting organisations and individuals from financial abuse, this will impact on the capacity of those practitioners exercising their duty of care at the front line. This means that practitioners are less able to engage with individuals to identify safeguarding issues and enable positive risk taking. Defensive risk management strategies or risk‐averse frontline practice may then result in individuals not being adequately supported to make choices and take control and, therefore, being put at risk. Practitioners need to be supported by local authorities to incorporate safeguarding and risk enablement in their relationship‐based, person‐centred working. Good quality, consistent and trusted relationships and good communication are particularly important for self‐directed support and personal budget schemes.

Originality/value

The use of “risk enablement panels” and “personalisation and safeguarding frameworks” are two ways to address some of the issues in practice.

Details

The Journal of Adult Protection, vol. 13 no. 3
Type: Research Article
ISSN: 1466-8203

Keywords

Article
Publication date: 20 September 2011

Lili‐Anne Kihn

The purpose of this study is to further our understanding of how and why interpretations of budget targets differ from one person to another even in the same business unit.

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Abstract

Purpose

The purpose of this study is to further our understanding of how and why interpretations of budget targets differ from one person to another even in the same business unit.

Design/methodology/approach

A qualitative case study research approach is adopted, involving a review and analysis of the literature and interviews conducted among controllers and managers of a highly successful business unit.

Findings

Both the theoretical and empirical results suggest that organizational budgetary processes do not provide a similar understanding of budget targets for each person. While some shared interpretations are evident, individual‐level variations occur in the personal and subjective meanings that controllers and managers give to budget targets in their own consciousness, situationality and corporeality. A personal historical basis for understanding may impact a manager's interpretation of budget targets, but the interpretations can also be dynamic and change over time.

Research limitations/implications

The study is both facilitated and limited by its basic assumptions and approaches, and the findings may be most relevant to companies with similar profiles. Nevertheless, the study furthers our understanding of the characteristics of controllers and managers and their perception of the meaning of this important feature of accounting in practice.

Practical implications

It could be highly useful to jointly discuss the intended primary purposes and nature of organizational budget targets. Otherwise, people may understand targets in different and perhaps even contradictory ways, which could in turn impair the functioning of control systems.

Originality/value

This paper contributes to current budgeting research in that it interprets individual‐level differences.

Details

Journal of Accounting & Organizational Change, vol. 7 no. 3
Type: Research Article
ISSN: 1832-5912

Keywords

Article
Publication date: 30 March 2022

Elizabeth Welch, Karen Jones, Diane Fox and James Caiels

Integrated care continues to be a central aim within health and social care policy in England. Personal budgets and personal health budgets aim to place service users at the…

Abstract

Purpose

Integrated care continues to be a central aim within health and social care policy in England. Personal budgets and personal health budgets aim to place service users at the centre of decision-making and are part of a wider long-term initiative working towards personalised and integrated care. Personal budgets began in social care with the national pilot programme of individual budgets, which aimed to incorporate several funding streams into one budget, but in practice local authorities limited these to social care expenditure. Personal budgets then moved into the health care sector with the introduction of a three-year personal health budgets pilot programme that started in 2009. The purpose of the paper is to explore the post-pilot implementation of personal health budgets and explore their role in facilitating service integration. We examine this through the RE-AIM framework.

Design/methodology/approach

During 2015 and 2016, eight organisational representatives, 23 personal health budget holders and three service providers were interviewed, 42 personal health budget support plans were collected and 14 service providers completed an online survey.

Findings

Overall, personal health budgets continued to be viewed positively but progress in implementation was slower than expected. Effective leadership, clear communication and longer-term implementation were seen as vital ingredients in ensuring personal health budgets are fully embedded and contribute to wider service integration.

Originality/value

The paper highlights the importance of policy implementation over the longer-term, while illustrating how the venture of personal health budgets in England could be a mechanism for implementing service integration. The findings can serve to guide future policy initiatives on person-centred care and service integration.

Details

Journal of Integrated Care, vol. 30 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

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