Self-direction and health care

Coverage

•in Control

•Self-Directed Support

•Key innovations

•Network for Social Innovation

•Independent social enterprise

•Led reform and innovation in Social Care

•Created concept of ‘Personal Budget’

•Network for Social Innovation

Filling the policy-practice gap

2003 Start of in Control - designs ‘Self-Directed Support’

2005 Policy interest in ‘Individual Budgets’

2006 in Control membership programme - 60 authorities

2006 DH launches ‘Individual Budget’ Pilot Programme

2006 in Control starts ‘Total Transformation’ - Oldham

2007 in Control membership over 100

2008 DH launches ‘Personalisation’ Programme

Self-Directed Support

•Why change was needed

•The new model for Social Care

•Key innovations

•What its achieved

Professional Gift Model

•Community merely a tax payer

• Services dominated by professional interests

• Individual is right-less - unable to identify or control their own support

•Resources are inflexible and cannot be personalised

• Perverse incentives set up for the individual and family

Citizenship Model

•Citizen at the centre

• Services negotiated

• Entitlements defined

•Community fully engaged

•Outcomes improved

Self-Directed Self-Directed SupportSupport

Self-Directed Support

1. Right to Independent Living

I can get the support I need to be an independent citizen

2. Right to a Personal Budget

I know how much money I can use for my support

3. Right to Self-Determination

I have the authority, support or representation to make my own

decisions

4. Right to AccessibilityI can understand the rules and

systems and be able to get help easily

5. Right to Flexible Funding

I can use my money flexibly and creatively

6. Accountability Principle

I should tell people how I used my money and anything I’ve learnt

7. Capacity PrincipleGive me enough help, but not too

much; I’ve got something to contribute too

Points of innovation

•Clarifying entitlements - PHBs

•Resource Allocation Systems

•Brokerage & care navigation

•Finding flexibilities

•Systems of control

•Individual Service Funds

•Using the internet

the logic of personal budgets

social justice & citizenship

©

Brokerage & Care Navigation

- not a person but a function

Resource Flexibility

•Self-determination - Ben’s Mum

•Direction - Jane’s Art Class

•Money - Margaret’s new family

•Home - Clive’s House

•Support - Keith’s personal trainer

•Community Life - Gavin’s season ticket

Person Representative Trust

Broker Provider Care Manager

Degrees of Control

Shop 4 Support

How it works

•Respecting professionals

•Empowering people

•Building partnerships

•Sharing success and information

Innovation from the ground ‘up’

What it means

•Influencing policy

•Focus on practical solutions

•Source of mutual support

•An exercise in citizenship...

Self-Direction in health