Commissioning for personalisation

Duncan MacKay, Head of Social Work Development, North Lanarkshire Council

June 2008

Duncan MacKay gave a presentation outlining his views on the link between personalisation and commissioning. Issues covered included:

  • What do people mean by the term personalisation? (DMc thinks personalised services are planned, designed and funded on an individual level)
  • In considering someone’s needs, don’t automatically equate this with services
  • The important issue is changing the balance of choice and control, not the method by which payment is made i.e. you shouldn’t have to move to direct payments to get a personalised service
  • Issues for councils around managing the market and ensuring that providers are there to provide services if all financial control handed over to individuals
  • Simon Duffy: providers who don’t provide a personalised service won’t survive – is it as black and white as that?
  • Providers can become too big to provide an individualised service
  • There will inevitably be changes in the way services are provided e.g. use of technology rather than sleepovers
  • The relationships between councils, providers and individuals will all change
  • Local authority’s role should be assessment (with more work done on self-assessment), public protection and measuring/reviewing outcomes i.e. NOT micro management
  • At the moment, reporting systems measure ‘old ways’ of doing things
  • Challenges to the personalisation agenda include efficient government, shared services, procurement, accountability of public funds and disparities in eligibility criteria.

There followed a Q&A/discussion session, during which the following issues were raised:

  • How does the idea of individualised services fit with rigorous contracting requirements?
  • People in social work aren’t confident about contracting and legal/financial contracts officers don’t understand social work
  • Providers should consider carefully whether or not they want to pursue business that is not personalised
  • How many local authority commissioners would share Duncan’s view?
  • Limits on flexibility of e.g. Working Time Directive
  • How to manage the risks of building up and using natural supports in individuals’ lives
  • Local authorities, individuals, their families and providers should all discuss and agree on risks
  • Why are people not demanding direct payments?
  • We need to demonstrate what is possible, which will build momentum
  • We need to raise people’s expectations, not be paternal
  • Some carers/people who use services don’t want to be in control
  • Do people start to view their financial allocation as an entitlement ?
  • Is there a risk that individuals get caught in the crossfire when e.g. la’s won’t give inflationary uplift (evidence from England of people rationing their own services)?
  • There is a great need for service re-design