The Health & Social Market Place
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Don Derrett gives an overview of the ups and downs of personalisation and self-directed support as it is developing in the UK. He explores some possible new directions.
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The Health & Social Market Place
- 1. The health and social ‘Market-place’
- 4. Outline history of the development of Self Direction in the UK by Person Centred Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 5. Outline history of the development of Self Direction in the UK by Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 6. Outline history of the development of Self Direction in the UK by Direct 1996 Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 7. Outline history of the development of Self Direction in the UK by Valuing People 2001 Direct 1996 Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 8. Outline history of the development of Self Direction in the UK by Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 9. Outline history of the development of Self Direction in the UK by in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 10. Outline history of the development of Self Direction in the UK by in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 11. Outline history of the development of Self Direction in the UK by Individual Budgets in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 12. Outline history of the development of Self Direction in the UK by Self Directed Support Individual Budgets in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 13. Outline history of the development of Self Direction in the UK by Personal Budgets Self Directed Support Individual Budgets in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 14. Outline history of the development of Self Direction in the UK by Resource Allocation System Personal Budgets Self Directed Support Individual Budgets in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 15. Outline history of the development of Self Direction in the UK by Resource Allocation System Personal Budgets Self Directed Phase 1 in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 16. Outline history of the development of Self Direction in the UK by Resource Allocation System Personal Individual Budget Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 17. Outline history of the development of Self Direction in the UK by Resource Allocation System Personal Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 18. Outline history of the development of Self Direction in the UK by Resource Allocation System Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 19. Outline history of the development of Self Direction in the UK by Resource Allocation System 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 20. Outline history of the development of Self Direction in the UK by Resource Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 21. Outline history of the development of Self Direction in the UK by Resource 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 22. Outline history of the development of Self Direction in the UK by Wales Alliance for Citizen Directed Support Scotland in Control Resource Personalisation 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 23. Outline history of the development of Self Direction in the UK by Wales Alliance for Citizen Directed Support Scotland in Control Change to Direct Payments 2009 Resource rules Personalisation 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 24. Outline history of the development of Self Direction in the UK by Wales Alliance for Citizen Directed Support Personal Health Budget 2010 Scotland Pilots in Control Change to Direct Payments 2009 Resource rules Personalisation 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 25. Outline history of the development of Self Direction in the UK by Personal Budgets for 30% Eligible for Social 2011 Wales Alliance for Care Citizen Directed Support Personal Health Budget 2010 Scotland Pilots in Control Change to Direct Payments 2009 Resource rules Personalisation 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 26. Outline history of the development of Self Direction in the UK by Think Local Act Personal Budgets for 30% Eligible for Social 2011 Personal Wales Alliance for Care Citizen Directed Support Personal Health Budget 2010 Scotland Pilots in Control Change to Direct Payments 2009 Resource rules Personalisation 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 27. Outline history of the development of Self 2013 Direction in the UK by Think Local Act Personal Budgets for 30% Eligible for Social 2011 Personal Wales Alliance for Care Citizen Directed Support Personal Health Budget 2010 Scotland Pilots in Control Change to Direct Payments 2009 Resource rules Personalisation 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 28. Outline history of the development of Self Personal Budgets for 100% Eligible for 2013 Direction in the UK by Social Care Think Local Act Personal Budgets for 30% Eligible for Social Personal 2011 Wales Alliance for Care Citizen Directed Support Personal Health Budget 2010 Scotland Pilots in Control Change to Direct Payments 2009 Resource rules Personalisation 2008 Allocation Putting People System First 2007 Independent Living Personal Strategy Individual Budget 2006 Budgets Self Directed Phase 1 Pilots in Control Support Individual Budgets 2005 Report in Control 2003 Individual Service Valuing People 2001 Funds Inclusion Direct 1996 Glasgow Payments Care in the 1990 Person Centred Community Planning Social Role 1980’s Valorisation Normalisation Government Author and copyright Don Derrett, Legislation and self direct
- 31. Sarah and Adam Photo from the self direct publication ‘Helping providers to change’ reproduced with kind permission of Gareth Buddho
- 32. Model of Self-Directed Support Author / copyright, Simon Duffy, Centre for Welfare Reform
- 33. The 7 Ethical Principles of Self-Directed Support Principles of Self-Directed Support © Don Derrett and Simon Duffy 2012
- 34. • 1. Independent living - we have the right to be a citizen with full access to ordinary lives “I have a right to live my life in a way that makes sense to me.” • 2. Entitlement - we are each entitled to enough support to achieve citizenship “I have a right to enough support and a right not to be over supported.” Principles of Self-Directed Support © Don Derrett and Simon Duffy 2012
- 35. • 3. Self-determination - we should be in control of our own lives “I have a right to make decisions about how I live my life and, if needed, I have a right to be supported by people who know me and love me to make those decisions for and with me.” • 4. Openness - we should be clear about any rules or systems “I have a right to be told clearly and simply how the system of entitlement works and how the rules affect me; including how much money I am entitled to for my support.” Principles of Self-Directed Support © Don Derrett and Simon Duffy 2012
- 36. • 5. Flexibility - we should be free to use our own entitlements as we see fit “I have a right to use my money in any way that helps me to live my life; including the freedom to take risks, make mistakes and learn from them.” Principles of Self-Directed Support © Don Derrett and Simon Duffy 2012
- 37. • 6. Learning - we should share what we are learning to help everyone “I have a responsibility to share with others what I have learnt works for me and what doesn’t work for me.” • 7. Contribution - we have a responsibility to contribute and to build stronger communities “I have a right and a responsibility to use my skills, talents and knowledge to play a full part as a citizen in my Principles of Self-Directed Support © Don Derrett and Simon Duffy 2012
- 38. Users of Social Care Personal Budgets Ipsos MORI report for the National Audit Office study on the Department of Health’s regulatory oversight of care markets 29 July 2011
- 39. Summary of Findings Choice and Personal Budgets Not all budget holders interviewed were offered the choice between a direct payment, a managed account, or a combination of the two. When a choice was offered, managed budgets were chosen when the benefit of a direct payment was outweighed by the added responsibility and work involved. Users of Social Care Personal Budgets Ipsos MORI report for the National Audit Office study on the Department of Health’s regulatory oversight of care markets 29 July 2011
- 40. Summary of Findings Choosing, managing and switching providers Managed budget holders were generally unaware that they could choose providers, and were not offered any choice of providers. Participants wanted to see lists of potential providers with feedback from other users to help them choose. Users of Social Care Personal Budgets Ipsos MORI report for the National Audit Office study on the Department of Health’s regulatory oversight of care markets 29 July 2011
- 41. Summary of Findings Choosing, managing and switching providers Support to manage and switch providers was crucial to ensure all users were able to exercise choice and get the most out of their personal budget, but it was not always available, or not always of the right quality. Users of Social Care Personal Budgets Ipsos MORI report for the National Audit Office study on the Department of Health’s regulatory oversight of care markets 29 July 2011
- 42. Summary of Findings Managing Risks As budget holders move away from traditional services to use a wider range of suppliers, and in particular venture further into mainstream services, the screening and accreditation of suppliers become more difficult for local authorities. Their response to this seems to be focused around information provision and collating user feedback, to help budget holders make informed decisions. Users of Social Care Personal Budgets Ipsos MORI report for the National Audit Office study on the Department of Health’s regulatory oversight of care markets 29 July 2011
- 43. Outcome Focused Support Planning Calderdale MBC Facilitated by
- 44. PATH (Planning Alternative Tomorrows with Hope) • Power with NOT • Power over
- 45. Training Personal Assistants, Help your PA support you better Pavilion Publication Booklet CD DVD
- 46. Personal Health Budgets “Health Secretary Andrew Lansley has announced that by April 2014, subject to the evaluation, people eligible for NHS Continuing Healthcare will have the right to ask for a personal health budget – including a direct payment.”
- 47. Australia
- 49. Julie Simpson Family Carer, self direct Australia www.selfdirect.org. au
- 50. Ethical Principle 1. Right to Independent Living Scenario Di’s experience of living an ‘Independent life’ in the community was a nightmare of discriminatory hate crime, she wanted to live Issue Do you take action when people say they want to move on from your service, or live somewhere else or change who they live with or who supports them? Identify a person who uses your service and a family member who you would involve in thinking about this. How would you support them? Example: Culture – “Listening to what people say about how they want to live”
- 51. Ethical Principle 1. Right to Independent Living Scenario Di’s experience of living an ‘Independent life’ in the community was a nightmare of discriminatory hate crime, she wanted to live Issue Do you take action when people say they want to move on from your service, or live somewhere else or change who they live with or who supports them? Identify a What culture person who change needs uses your to take place in service and a the family member organisation who you would and how do involve in you go about thinking about this? this. How would you support them? Example: Culture – “Listening to what people say about how they want to live”
- 52. Ethical Principle 1. Right to Independent Living Scenario Di’s experience of living an ‘Independent life’ in the community was a nightmare of discriminatory hate crime, she wanted to live Issue Do you take action when people say they want to move on from your service, or live somewhere else or change who they live with or who supports them? Identify a What culture What policy / person who change needs procedure uses your to take place in needs to service and a the change or be family member organisation created in who you would and how do order to involve in you go about support that thinking about this? culture change this. How and how do would you you go about support them? this? Example: Culture – “Listening to what people say about how they want to live”
- 53. Ethical Principle 1. Right to Independent Living Scenario Di’s experience of living an ‘Independent life’ in the community was a nightmare of discriminatory hate crime, she wanted to live Issue Do you take action when people say they want to move on from your service, or live somewhere else or change who they live with or who supports them? Identify a What culture What policy / What, were or person who change needs procedure would be the uses your to take place in needs to outcomes for service and a the change or be the individual? family member organisation created in who you would and how do order to involve in you go about support that thinking about this? culture change this. How and how do would you you go about support them? this? Example: Culture – “Listening to what people say about how they want to live”
- 54. What next for self direct? • Raising expectations • Get information directly to people • Develop new products to support people to maintain and take control of their lives • Work with the membership
- 55. Achievement
- 56. What’s holding people back
- 58. Things that make your heart sing
- 60. Don’t neglect what has already been achieved
- 61. Moving on with the changes
- 65. New boo
- 66. Thanks for
- 67. Don Derrett Chief Executive, self direct & Fellow of The Centre for Welfare Reform www.selfdirect.org
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