An introduction to ISFs from a commissioning perspective.

1. About Individual Service
Funds (ISF’s) in England

2. Our mission…
© Simon Duffy

3. Consultancy
Self-Directed Futures provides practical assistance, training and consultancy to a whole range
of organisations including: support providers, voluntary and community sector organisations;
clinical commissioning groups; local authorities and others who aspire to make radical change
for the benefit of citizens. The collective knowledge, skills and experience of our associates
means that we are able to provide practical advice and support on a whole range of issues -we
help with:
• Co-production & visioning
• Commissioning for personalisation
• Training around SDS
• Market engagement and market shaping to support SDS
• Stakeholder consultation
• Coaching & mentoring
• Evaluations
• Embedding culture change

4. Just so you know a bit about me
• In the early part of my career I worked in a range of settings
with people providing support – I was a support worker in NHS
inpatient units, involved in homecare, residential care,
supported housing, day services and worked as a personal
assistant and also ended up managing these ‘services’.
• I then spent 12 years involved in adult social care
commissioning (NHS/LA), working alongside social workers
and allied health professionals and overseeing many of the
types of ‘services’ that I had worked in previously.
• These insights have enabled me to set up an organisation
Self-Directed Futures – we work with LA’s and CCG’s across
the England promoting different ways of personalising
commissioning and shifting the locus of control over to people
and families.
• I am also a consultant with the Institute of Public Care and run
a small non CQC registered organisation in Dorset supporting
adults with learning disabilities using personal budgets.

5. Individual Service Funds
are about citizenship
© Simon Duffy
• Moving away from the ‘professional gift’
• Away from people being seen as
grateful recipient of services
• Towards having clear entitlement to a
personal budget
• Freedom to use creativity and own
judgment
• People want to build good lives not just
to receive services

6. Moving away from top down
commissioning…
© Self-Directed Futures

7. Towards real co-production
& innovation

8. …and commissioning
support for a year at a
time

9. People are having their lives
fixed for 12 months at a time
9
Point of 12 month review and
personal budget readjustment

10. What are Individual Service Funds
(NHS Third Party Budgets)?
© Simon Duffy
• It’s the persons entitlement after
assessment
• Are a commissioned arrangement
(unlike Direct payments)
• A ‘personal budget’ held by a
nominated organisation on behalf
of a person

11. Simple ISF arrangement
• Assessment and support plan
details who the person would like to
hold their ISF
• Agreement between the funder and
the ISF holding organisation
• Agreement between the person and
their ISF holding organisation
setting out how they will work
together to use their budget
© Self-Directed Futures

12. How ISFs/TPPHB’s can help
12
 A support provider or a third party
holds the personal budget
 People and families work with them
to decide how to use it to meet
outcomes (agreed by holding org
and commissioners)
 It is money for support that is held
on behalf of the person and they
direct how its used in a 3 way
partnership

13. What’s different about an ISF/TPPHB

14. 1. The council will work
out how much money
you have in your ISF
Individual Services Funds (ISF) – step by step how they work
2. You choose who you
want to hold your ISF
for you
3. They will then work with
you to make a support plan
4. The council will
check this plan and sign
to say its been agreed
6. Your ISF holder will then
set up your payments with
the council and get the
money into your ISF
account
7. They will then set up your
support for you as agreed in your
plan
5. You will agree and sign your
Individual Service Fund
Agreement (your provider will
help you with this and it can be
done as a best interest decision)
8. You can then get on
and live your life
9. After you and the ISF
holder will meet with
the council and check
how it is all working

15. What the Care Act guidance
says
The person can choose for the personal
budget allocation to remain with the local
authority to arrange care and support on the
person’s behalf, and in line with their wishes.
Alternatively, if available locally, it can be
placed with a third-party provider on the
same basis, often called an individual
service fund (ISF).
Where an ISF-type arrangement is not
available locally, the local authority should
explore arrangements to develop this
offer, and should be receptive to requests
from personal budget recipients to create
these arrangements with specified providers.

16. NHS Third Party budgets
….. People can have a personal budget, integrated personal budget or personal health budget in
one, or any combination of these three ways:
• Notional budget: the local authority or the NHS manages the budget and arranges care and
support.
• Third party budget: an organisation independent of the
person, the local authority and NHS commissioners
manages the budget and is responsible for ensuring the
right care is put in place, working in partnership with the
person and their family to ensure the agreed outcomes
can be achieved.
• Direct payment: the budget holder has the money in a bank account or an equivalent account,
and takes responsibility for purchasing care and support.
The budget may be held by the person or by someone else acting on the person’s behalf…..
Clinical commissioning groups (CCGs) and local authorities should ensure that all three options
are available.7

17. ISF/TPPHB arrangement

18. Research on ISFs
The following chart
shows how lives
changed for 24
individuals who used
ISFs between 2008 -
2014
Individual Service Funds LEARNING FROM INCLUSION'S 18 YEARS OF PRACTICE, Animate 2014, The Centre for Welfare Reform

19. Wakefield ISF survey (2020)
Individual Service Funds LEARNING FROM INCLUSION'S 18 YEARS OF PRACTICE, Animate 2014, The Centre for Welfare Reform

20. • Place choice, control and power with people and families
• Nearly all the benefits of Direct Payments but without the
administrative worry of being an employer
• People can make adjustments to their day to day support
without having to go back to social work teams or
commissioners (as long as it meets outcomes)
• Current contracts are mainly inflexible – they are also
wasteful
So why are ISFs good?

21. Examples of ISFs in practice
• Bev – flexible sleep ins
• Luke – flexible day services
and confidence building
therapies
• Trudy – swapped day
services for pooled budget
with friend and an allotment

22. Benefits of ISF vs commissioned support?
ISF Commissioned
Paid like a direct payment – usually in
advance (4 weeks to 12 months)
Paid in arrears via invoice
Working in stronger partnership with
social services to deliver support asa
form of trusted reviewer
Deliver support as specified by social
services
Co produce support plan with the
person and keep it ‘live’ and make
decisions day to day with the person
Given a social services support plan to
follow
Can lead commission and organise
other services that the person needs -
more flexible
Social services commission all
elements of support package – less
flexible

23. Where do these arrangements work best?
23
Workforce guidance developed by Skills for Care
(2020) noted they work best for:
● Want to have more choice and control over who
provides their support and to have the flexibility be
able to change things regularly as required.
● Are looking to work in partnership with their
support provider or broker organisation to find
creative solutions.
● Want more specialised support arrangements to
meet complex needs.
● Do not want the responsibilities of being an
employer of PAs or managing their day- to-day
support arrangements without help.
● To cooperate with others and pool their budgets
to buy shared support or activities (in shared
housing settings for example).

24. Common misconceptions around ISFs
• It is optional for commissioners to
offer them so we don’t need to act
• We will lose income by offering ISFs
• We will have to make staff redundant
• There will be no need for
commissioners/providers
• We won’t be able to change our
systems and culture
The Skills for Care guidance covers all these issues in detail

25. ISFs in a personalised eco system

26. Progress on ISFS 2018
https://citizen-network.org/resources/map-of-isfs-in-england.html

27. Progress on ISFs 2021
https://citizen-network.org/resources/map-of-isfs-in-england.html

28. Areas we are supporting
✅ Essex County Council
✅ Bristol City Council (adults plus
Children’s services)
✅ Norfolk County Council
✅ Dorset Council
✅ Somerset County Council
✅ Luton Council
✅ Warwickshire County Council
✅ Cambridgshire County Council
In conversations with:
✅ Dudley MBC
✅ Sheffield City Council
✅ Herefordshire County Council
✅ Lancashire County Council
© Self-Directed Futures

29. Further Reading

30. https://citizen-
network.org/resources/
selfdirected-support-
network.html

31. Luke’s ISF
https://www.selfdirectedfutures.co.uk/lukes-story

32. DOSH ISF easy to
understand Video
https://vimeo.com/352026373/2fcce355ac

33. Callum’s ISF Story
Video
http://in-controlscotland.org/sds-cinema/calum-and-moiras-story-on-using-an-individual-service-fund/

34. Q&A