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How care providers can help negotiate the maze of personal budgets.

Posted on:    September 13, 2013

Individual service funds remove the stress of budgeting for vulnerable clients, but they will require trust from commissioners

The demand for personalised care services which champion individual choice has never been more pressing. Regrettably, this demand for costly bespoke care has risen just at the point when public spending is severely constrained.

Individual service funds offer a unique opportunity to do more with less: cutting out unnecessary commissioning work, and concentrating on what really matters to people who use Social Care services.

An individual service fund (ISF) is one way of managing a service user’s personal budget. The commissioning body – usually a local authority – pays the budget in instalments directly to a care provider. The provider assumes responsibility for agreeing a plan of care directly with the service user, and is free to adjust the plan over time to meet changing needs and preferences while sticking within the budget. The provider may deliver the required services itself, or commission them from other organisations and the local community.

The major benefit of an ISF is that it offers service users the ability to design a personal, flexible care plan without needing to manage the personal budget directly or employ a personal assistant to do so. Managing a budget can be a daunting prospect, and fraught with unanticipated consequences for many people.

ISFs also overcome the “time and task” approach to care that has regrettably become associated with services commissioned directly by councils. This can result in a care plan comprised of a range of “typical tasks” specified in a council contract, delivered at predetermined times of the day or week and very difficult to change.

By contrast, an ISF opens up a level of personal control, similar to that enjoyed by those using private funds to pay for care, and with the added confidence of using a regulated care provider.

The move away from task-based commissioning is timely as the government has committed to “rule out crude contracting by the minute” in England. These independent funds are a potential response to make the best use of constrained spending, rather than crudely cutting time spent with service users. If we accept the government’s argument that there is no new money for social care, then let us at least make sure that it is the people who use services who decide how their needs are met from their personal budget.

The use of ISFs also creates a new dynamic in the commissioing process. The responsibility for devising and reviewing care plans is shifted to the service user, and their personal provider. Commissioners step back from this core part of their traditional role; their primary focus is to specify compliance requirements, determine outcomes, allocate the personal budget and, finally, monitor satisfaction with the service.

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