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Whole System Change
                    the meaning of personalisation




                          Dr Simon Duffy The Centre for Welfare Reform
                          for North Lanarkshire Council 8th November 2011



Tuesday, 15 November 11
The Centre for Welfare Reform

           • voluntary fellowship of over 60
                  innovators

           • belief in human equality, and the value
                  of diversity

           • welfare state is good, it’s just designed
                  wrong

           • independent of political parties,
                  government and big business

Tuesday, 15 November 11
Remember - personalisation

           • was (largely) developed in Scotland
           • is about greater social justice
           • changes the whole system
           • requires care to implement well


Tuesday, 15 November 11
“personalisation” is used
      in many different ways




Tuesday, 15 November 11
technologies rooted in values




Tuesday, 15 November 11
4 key developments

           • Direct payments - Hampshire
           • Individual budgets - Glasgow
           • Self-directed support - North Lanarkshire
           • Resource allocation systems - Wigan
           • of course, many more innovations...
           • and its an international movement...
Tuesday, 15 November 11
Direct
     payments...




      power, with many limitations
Tuesday, 15 November 11
Whose money?




              for services, or for people
Tuesday, 15 November 11
Individual budgets




        from push to pull economics
Tuesday, 15 November 11
Tuesday, 15 November 11
Individual budgets




             not shopping - community
Tuesday, 15 November 11
Tuesday, 15 November 11
Self-directed support




               change the whole system
Tuesday, 15 November 11
Tuesday, 15 November 11
Social justice at the root




              citizenship
Tuesday, 15 November 11
Social justice at the root




            real
            wealth
Tuesday, 15 November 11
Social justice at the root




Tuesday, 15 November 11
Case study



            Personalised
            Transition...




Tuesday, 15 November 11
Tuesday, 15 November 11
Jonathan’s story
      For the 3 years before 150 days in hospital -
      responding to problems with breathing.
      In the 3 years after leaving hospital he has spent
      only 2 nights in hospital - for elective dental
      treatments.
      Personalised learning - on the job - 2 City & Guilds
      Qualifications.
      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
Tuesday, 15 November 11
Implementation hazards

           1.targets, instead of clear entitlements

           2.complexity, instead of simple systems

           3.new professionals, instead of community

           4.undermining, not respecting professionals


        learn from England and do different
Tuesday, 15 November 11
1. focus on entitlements

           • revisit ‘health and social care’
           • remove charging - ‘disability super tax’
           • create more flexibility
           • clarify and strengthen entitlements
  early targets drive down quality - areas
  will do it if its legal and it works!
Tuesday, 15 November 11
resistance to innovation




    its natural - so don’t cheat...
Tuesday, 15 November 11
2. focus on simple systems

           • NOT systems added on top of old
           • NOT new more paperwork
           • NOT more complex planning
           • NOT monitoring the wrong things

            normalise - make stuff easy
Tuesday, 15 November 11
unlock community capacity




Tuesday, 15 November 11
3. focus on community
           1.share information

           2.enable peer support

           3.work with community organisations

           4.use service providers as allies

           5.respect professional skills



Tuesday, 15 November 11
Tuesday, 15 November 11
4. focus on the front-line
           • empowerment is compatible with good
                  practice

           • front-line professionals can own and
                  develop these ideas

           • leaders need to remove burdens
           • remember words are not enough


Tuesday, 15 November 11
ending care management...




                          ...rescripting social work
Tuesday, 15 November 11
Remember - personalisation

           • is not foreign - you made it
           • is based on your values
           • is fundamental to a better system
           • works - so make use of its power


Tuesday, 15 November 11
Scottish
                          Campaign
                          for a Fair
                          Society



Tuesday, 15 November 11
personalisation
                          through
                          collective
                          action




Tuesday, 15 November 11
For more information go to
        www.centreforwelfarereform.org




                            These slides are © Simon Duffy 2011 Publisher is The
                            Centre for Welfare Reform Slides can be distributed subject
                            to conditions set out at www.centreforwelfarereform.org


Tuesday, 15 November 11

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Whole System Change, the meaning of personalisation - Simon Duffy

  • 1. Whole System Change the meaning of personalisation Dr Simon Duffy The Centre for Welfare Reform for North Lanarkshire Council 8th November 2011 Tuesday, 15 November 11
  • 2. The Centre for Welfare Reform • voluntary fellowship of over 60 innovators • belief in human equality, and the value of diversity • welfare state is good, it’s just designed wrong • independent of political parties, government and big business Tuesday, 15 November 11
  • 3. Remember - personalisation • was (largely) developed in Scotland • is about greater social justice • changes the whole system • requires care to implement well Tuesday, 15 November 11
  • 4. “personalisation” is used in many different ways Tuesday, 15 November 11
  • 5. technologies rooted in values Tuesday, 15 November 11
  • 6. 4 key developments • Direct payments - Hampshire • Individual budgets - Glasgow • Self-directed support - North Lanarkshire • Resource allocation systems - Wigan • of course, many more innovations... • and its an international movement... Tuesday, 15 November 11
  • 7. Direct payments... power, with many limitations Tuesday, 15 November 11
  • 8. Whose money? for services, or for people Tuesday, 15 November 11
  • 9. Individual budgets from push to pull economics Tuesday, 15 November 11
  • 11. Individual budgets not shopping - community Tuesday, 15 November 11
  • 13. Self-directed support change the whole system Tuesday, 15 November 11
  • 15. Social justice at the root citizenship Tuesday, 15 November 11
  • 16. Social justice at the root real wealth Tuesday, 15 November 11
  • 17. Social justice at the root Tuesday, 15 November 11
  • 18. Case study Personalised Transition... Tuesday, 15 November 11
  • 20. Jonathan’s story For the 3 years before 150 days in hospital - responding to problems with breathing. In the 3 years after leaving hospital he has spent only 2 nights in hospital - for elective dental treatments. Personalised learning - on the job - 2 City & Guilds Qualifications. 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 Tuesday, 15 November 11
  • 21. Implementation hazards 1.targets, instead of clear entitlements 2.complexity, instead of simple systems 3.new professionals, instead of community 4.undermining, not respecting professionals learn from England and do different Tuesday, 15 November 11
  • 22. 1. focus on entitlements • revisit ‘health and social care’ • remove charging - ‘disability super tax’ • create more flexibility • clarify and strengthen entitlements early targets drive down quality - areas will do it if its legal and it works! Tuesday, 15 November 11
  • 23. resistance to innovation its natural - so don’t cheat... Tuesday, 15 November 11
  • 24. 2. focus on simple systems • NOT systems added on top of old • NOT new more paperwork • NOT more complex planning • NOT monitoring the wrong things normalise - make stuff easy Tuesday, 15 November 11
  • 26. 3. focus on community 1.share information 2.enable peer support 3.work with community organisations 4.use service providers as allies 5.respect professional skills Tuesday, 15 November 11
  • 28. 4. focus on the front-line • empowerment is compatible with good practice • front-line professionals can own and develop these ideas • leaders need to remove burdens • remember words are not enough Tuesday, 15 November 11
  • 29. ending care management... ...rescripting social work Tuesday, 15 November 11
  • 30. Remember - personalisation • is not foreign - you made it • is based on your values • is fundamental to a better system • works - so make use of its power Tuesday, 15 November 11
  • 31. Scottish Campaign for a Fair Society Tuesday, 15 November 11
  • 32. personalisation through collective action Tuesday, 15 November 11
  • 33. For more information go to www.centreforwelfarereform.org These slides are © Simon Duffy 2011 Publisher is The Centre for Welfare Reform Slides can be distributed subject to conditions set out at www.centreforwelfarereform.org Tuesday, 15 November 11