Tuesday, 25 November 2008

Individual Budgets, new opportunities for the VCS?

Over a decade ago the government introduced a system called Direct Payments which provided the option of means tested cash payments to service users for the purchase of services to meet their care needs. A new system named Individual Budgets, currently being piloted across 12 sites (The findings will be published towards the end of 2008), will be a development of the benefits currently on offer through the Direct Payments scheme. Individual Budgets will give users the option of taking their budget as a direct payment, let the council commission services on their behalf, or as a combination of the two.

The new system of Individual Budgets is influenced by health care reform. Key messages from government policy that inform the developments:
• Independent living
• Staying healthy
• Choice
• Sustaining families and children not inappropriately undertaking caring responsibilities
• Improving quality of life
• Dignity, respect and free from discrimination

To achieve this Individual Budgets will place the user at the centre of decisions over their care package, supporting them to choose from a greater range of services, from a greater range of providers (including friends and relatives) that is most appropriate to their needs. It represents a more holistic approach to health that also includes preventative rather than crisis led solutions. For example, a user who needs support with their shopping may opt for a package that includes meeting with a befriender, going to the shops with them and having a coffee and a chat afterwards.

As Individual Budgets are currently still in development and the model differs in each locality it is impossible to outline here exactly how the system will work. The assessment will include a multiple choice self-assessment questionnaire, generating a score that will determine level of financial support and the type of support required to meet the identified priorities. There will be a menu of services for the user to choose from, though they can identify services outside of this. A plan will then be agreed between the service user and social worker. Some pilots have commissioned a third party organisation as a broker service to manage the relationship between service user and provider, including taking the employer responsibility on behalf of the service user.

VCS organisations can and do provide services under the existing Direct Payments scheme. Clearly the development of choice and of ‘whole person’ care plans, the inclusion of preventative services and the addition of existing funding streams to the Individual Budgets scheme presents the VCS with new opportunities. As the VCS looks to diversify and develop the range of income it generate Individual Budgets could be a real opportunity to sell its services. As the scheme is not yet developed locally we cannot specify how VCS organisations might engage with Individual Budgets. The information currently available indicates that little or no additional requirements would be placed on VCS organisations (those currently delivering funded services). The organisation would have to position its services to meet the needs of Individual Payment service users. A unit cost would need to be calculated, a practice not commonly used or required of the VCS at the moment. The organisation would need to consider if there was a conflict if they were in a position where the provision of ‘paid for’ services were the same as services already provided through a grant or contract.

HealthNet will keep you updated on developments as they happen and provide direct support to VCS organisations once Individual Payments are sufficiently developed locally.

Any questions, comments or information requests contact Rachel or Razwanah @ HealthNet (Bradford CVS) t: 01274 722772 or e: health@bradfordcvs.org.uk

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