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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…

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

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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…

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

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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

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Article
Publication date: 1 December 2006

Martin Stevens

This article presents plans to evaluate the individual budget pilots in England. The setting up of the 13 pilot projects is described, and the evaluation's questions and…

Abstract

This article presents plans to evaluate the individual budget pilots in England. The setting up of the 13 pilot projects is described, and the evaluation's questions and approaches are outlined. The article outlines some of the central challenges being encountered as the pilots get under way.

Details

Journal of Integrated Care, vol. 14 no. 6
Type: Research Article
ISSN: 1476-9018

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Article
Publication date: 22 July 2009

Edward Hall

A central element in the shift to a ‘personalised’ care system in the UK is the opportunity for disabled people to hold and manage budgets for the purchase of care and…

Abstract

A central element in the shift to a ‘personalised’ care system in the UK is the opportunity for disabled people to hold and manage budgets for the purchase of care and support, to replace local authority services. The delivery mechanisms of ‘Direct Payments’ and ‘Individual Budgets’ have allowed many disabled people to control their care and support better, and have promoted their social inclusion. However, the particular contexts and issues for people with learning disabilities in holding personal funding have been little considered. The paper sets out the broad themes of the introduction of personalised care, and examines the limited use by people with learning disabilities of Direct Payments and the subsequent development of Individual Budgets. The paper considers the challenges to the nature, spaces and relations of care commonly used by people with learning disabilities that personal budgets present, in particular for those with more severe disabilities. The paper concludes by suggesting ways in which people with learning disabilities can use personal budgets, whilst maintaining the collective relations and spaces of caring desired by many.

Details

Mental Health Review Journal, vol. 14 no. 2
Type: Research Article
ISSN: 1361-9322

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Article
Publication date: 1 October 2008

Martin Routledge and Zoe Porter

Personal budgets are part of the Putting People First agenda in England and are at the heart of the biggest change in social care for decades. This article discusses the…

Abstract

Personal budgets are part of the Putting People First agenda in England and are at the heart of the biggest change in social care for decades. This article discusses the rationale and evidence base behind their introduction and focuses on the challenges to moving from small scale pilots to nationwide implementation.

Details

Tizard Learning Disability Review, vol. 13 no. 3
Type: Research Article
ISSN: 1359-5474

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Working with Older People, vol. 10 no. 3
Type: Research Article
ISSN: 1366-3666

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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…

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

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Article
Publication date: 14 October 2009

Sara Weech

This article describes the journey that West Sussex PCT and County Council have set out on to test and experiment how personalisation in health can improve patient…

Abstract

This article describes the journey that West Sussex PCT and County Council have set out on to test and experiment how personalisation in health can improve patient outcomes and experience of health care. The journey is far from over, but the article describes the importance of top‐level commitment and leadership, the progress we have made, the lessons we have learned and some of the challenges we see ahead. It is about local action and learning, and does not presume to suggest it is the right or the best approach. The article is a case study to follow up the article about self‐directed support in health by Rita Brewis in the previous Issue of this journal. West Sussex is a provisional DH pilot area for the introduction of personal health budgets, and is a member of the Staying in Control programme. West Sussex County Council has been an individual budget pilot site, and has nearly 2,000 people receiving individual budgets and a target that all adults receiving social care will be offered self‐directed support by April 2010.

Details

Journal of Integrated Care, vol. 17 no. 5
Type: Research Article
ISSN: 1476-9018

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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…

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

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