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Personalisation & the Third Sector

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Talk given to leaders from Lancashire's Third Sector and Local Authority on the meaning of personalisation and the challenges for properly engaging civil society.

Talk given to leaders from Lancashire's Third Sector and Local Authority on the meaning of personalisation and the challenges for properly engaging civil society.

Published in Health & Medicine , Education
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Transcript

  • 1. Personalisation & the Third SectorDr Simon Duffy ■ The Centre for Welfare Reform ■ ThirdSector Lancashire ■ Chorley ■ 9th May 2012
  • 2. Simon Duffy of The Centre for Welfare Reform• In 1990 began work with people with learning difficulties to help shift power and control over the money to them and their families• Invented Individual (personal) Budgets and Self-Directed Support in Scotland• In 1996 began Inclusion Glasgow, and In Control in 2003 to test and develop these ideas• In 2009 began The Centre for Welfare Reform
  • 3. The welfare state isa good thingit’s just designed wrong
  • 4. Professional Gift Model• No entitlements - help provided as a ‘gift’ not a right• No freedom - solutions dictated by professionals/commissioners• No community - taken for granted or excluded• No partnership - services not accountable to people
  • 5. People were not free... ...people were not really included.
  • 6. The Spectrum of Services£200,000£150,000£100,000 £50,000 £0 Specialist Placements 24 Individual Support Group Homes Specialist Day Services Residential Colleges Nursing Homes Residential Homes Individual Day Supports Day Services Adult Placements Outreach Supports Domicilary Care Residential Respite
  • 7. Numbers using services40032024016080 0 Specialist Placements 24 Individual Support Group Homes Specialist Day Services Residential Colleges Nursing Homes Residential Homes Individual Day Supports Day Services Adult Placements Outreach Supports Domicilary Care Residential Respite
  • 8. Expenditure£15,000,000£11,250,000 £7,500,000 £3,750,000 £0 Specialist Placements 24 Individual Support Group Homes Specialist Day Services Residential Colleges Nursing Homes Residential Homes Individual Day Supports Day Services Adult Placements Outreach Supports Domicilary Care Residential Respite
  • 9. The balance8% 92% Segregated Services Community Services
  • 10. The currentsystem doesn’tmake senseIt spends ourmoney for us, onthings we wouldn’tbuy for ourselves
  • 11. Citizenship Model• Clear entitlements - my rights as a citizen• Freedom - I am an expert in my needs• Community - I can play my full part• Partnership - I am equal to professionals
  • 12. This is not an easy transformation...
  • 13. Personalisation involves big changes
  • 14. In England Personalisation is amixture of helpful reform, rhetoricalbluster and unresolved policy-making.In communities its value dependsupon the vision and understanding ofleadership - at every level - not justthe so-called ‘top’.Lancashire has a good head start.
  • 15. Some practical suggestions1.Develop personalised support2.Use Individual Service Funds (ISFs)3.Provide community brokerage4.Enable peer support5.Think beyond adult social care6.Challenge ‘procurement’7.Build bridges, lobby and campaign
  • 16. 1. Personalised Support Direct payments and employing your own staff is brilliant for some people... ...but many people want support that fits them, without all that extra hassle
  • 17. Individualise:• My life - designed• My staff - right people• My rights - in control• My rules - safe• My money - protected
  • 18. 2. Individual Service Fund
  • 19. Individual Service Funda model with many applications...
  • 20. Providers as...• Planners - lead thinking• Innovators - flexibility• Connectors - in community• Agents - safeguarding• Rationers - real expertise
  • 21. 3. Community brokerage
  • 22. Brokerage should notrequire a new breed ofindependent, fundedprofessionals, instead:• Information is free• People can do it• Peers will help• Communities can include• Providers must market
  • 23. new models are developing building oncommunity strengths
  • 24. Social Work Rescriptdemands a new approach from ASC
  • 25. 4. Peer support
  • 26. PFG generated quarter of a million pounds of value in one year
  • 27. Peer support:• Simple - not a service• Growing - the will is there• Natural - facilitate it• Powerful - passionate• Challenging - listen to it
  • 28. 5. Children, health, education...
  • 29. Jonathan’s storyFor the 3 years before 150 days in hospital -responding to problems with breathing.In the 3 years after leaving hospital he has spentonly 2 nights in hospital - for elective dentaltreatments.Personalised learning - on the job - 2 City & GuildsQualifications.Saving NHS, LA & Education•Over £100,000 in hospital stays•Over £300,000 in residential care costs•Over £100,000 of funding contributed by the LSC
  • 30. “A couple of weeks ago in Sheffield, I met awonderful woman called Katrina. Shes got threedisabled sons. The oldest is Jonathan, a charming,warm hearted young man of 19. He cant walk ortalk clearly, or feed himself alone. Hes had abreathing tube in his neck since he was a toddler....“Now hes doing work with a local charity, attendinga music group, has his own personal assistant...“Finally as a young man, engaged in life in a way heand his mother never thought possible. Katrina toldme with the biggest smile Ive ever seen, she said:Weve gone from having nothing to havingeverything.“I wish every childs needs would be taken thisseriously.”Nick Clegg, 17 September 2008.
  • 31. Major opportunities• End of life care• Mental health• Out of area placement• Continuing Health Care• Frequent users• Integrated care
  • 32. Most people want to die athome, but few do (only c. 15%) instead they die in expensive, institutional environments. Providing support at home is cheaper and better for individuals and families. The NHS could save c. £420 million per year by enabling personalised support at home.
  • 33. Personalised pathwaywe know how to connect up all the dis-jointed services we just need to want to do it
  • 34. 6. Investment not procurement
  • 35. 7. Political challenges
  • 36. www.campaignforafairsociety.orgPersonalisation is not a panacea for every problem in the welfare system. Personalisation is often undermined by underlying ambiguities. We need to campaign for...
  • 37. 1.Human rights - not services2.Clear entitlements - not confusion3.Early support - not crisis4.Equal access - not institutional care5.Choice and control - not dependence6.Fair incomes - not insecurity7.Fair taxes - not targeted8.Financial reform - sustainable
  • 38. We still have a long way to go...
  • 39. Some practical suggestions1.Develop personalised support2.Use Individual Service Funds (ISFs)3.Provide community brokerage4.Enable peer support5.Think beyond adult social care6.Challenge ‘procurement’7.Build bridges, lobby and campaign
  • 40. For more information go towww.centreforwelfarereform.org These slides are © Simon Duffy 2012 ■ Publisher is The Centre for Welfare Reform ■ Slides can be distributed subject to conditions set out at www.centreforwelfarereform.org ■