Comment Blog 1 March, 2019

Learning from peers: building capacity for personal budgets

As Reform’s latest report reveals, the use of personal budgets across public services is on the rise. A ring-fenced allocation of money from a commissioner to an individual to help meet their needs, personal budgets seek to replace the traditional top-down one-size-fits-all approach to public services.

Yet this expansion of personal budgets into different areas of public services has the potential to add additional burdens to frontline and administrative staff if not prepared for correctly, particularly in areas where personal budgets have not been extensively used before. The National Audit Office and social care professionals both argue that the success of personal budgets is heavily dependent upon the personal budget holder receiving adequate support and information to effectively procure their own services. A failure to provide this assistance could lead to worse outcomes for service users or a public service model that fails to deliver value for money.

I have argued in a previous blog that part of these additional demands could be mitigated by improving the digital information landscape. Yet this is not a complete solution. Many personal budget holders could be unable to access information about services, products, and providers digitally, including those with cognitive impairments. Consequently, it is necessary that other information networks are utilised to support personal budget holders. Existing frontline and administrative staff with whom service users have the most interactions are the obvious focus, particularly if they are given the role of advisors and enablers, tasked with engaging in specifics of people’s lives and providing citizens with solutions, rather than simply providing public services in traditional ways.

This shift to co-production between staff and citizens is crucial but presents its own challenges. Already stretched thin by a decade of austerity policies and growing demands on public services, evaluations of existing personal budget schemes suggest that the knowledge-base of frontline staff or their ability to disseminate information about personal budgets is inadequate in many service areas. This may be due to inexperience (such as when personal budgets have not been used in that service before), capacity (overworked staff), or cultural resistance (where staff are reluctant to adopt new models). As personal budgets spread to new areas, these challenges will likely increase.

The emphasis needs to be on ensuring that staff in areas with personal budgets schemes receive additional training on their duties surrounding personal budgets as part of their professional training. Several pilot schemes have highlighted how integral one-to-one advisers are to the successful implementation of personal budgets or direct payments, particularly from the perspective of the service users. For instance, the Youth Employment Gateway (YEG) scheme in Liverpool used a one-to-one adviser support model in which the adviser provided personally-tailored advice and support to meet the recipients’ individual needs at the right time. Over 90 per cent of YEG participants “agreed” or “strongly agreed” that their personal adviser “was the most important aspect of the YEG programme”.

Furthermore, frontline staff do not need to work alone. A Social Care Institute of Excellence report argued that “support provider organisations” can often be as crucial to improving the outcomes of personal budget holders as written information or frontline staff. Personal budget holders should be encouraged to utilise independent organisations and groups for advice and support, such as Independent Living Advisors (ILAs). Typically employees of a third-sector or not-for-profit organisation (such as the Penderels Trust), ILAs provide guidance and information for budget holders about administering their personal budgets. Alongside peer-to-peer advocacy groups, ILAs, like Aspire, work with frontline staff from the NHS and other public bodies to “ensure the patients’ questions are answered, often signposting them on to other organisations and working through solutions with the individuals.” Because ILAs work solely as advisors, they are able to dedicate more time and provide a greater depth of knowledge to supporting personal budget holders than frontline staff, at no additional cost to the individual.

In areas where personal budgets are being used or rolled-out, steps should be taken by local authorities and providers to ensure that training rectifies the current paucity of knowledge around personal budgets and embrace the integrated approach to personalised public services. The SCIE, for instance, offers a tailorable one-day training course for staff and organisations within the social care area to better understand their obligations in regard to personal budgets. The accessibility of this course for staff and organisations could be greatly increased by offering it digitally and integrating key lessons into in-house training provided by public bodies. Furthermore, there needs to be a greater emphasis on collaboration between government bodies, public sector workers, third-sector organisations, and peer-to-peer advocacy groups, as seen in the YEG scheme.

Josh Pritchard is a Researcher at Reform and co-author of the report 'Proceed with caution: What makes personal budgets work?'