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Personalisation agenda 'poses major challenges'

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Some councils are dragging their feet over the introduction of personal budgets for social care and are on course to miss key milestones for their implementation, the Audit Commission has said.

The news comes just days before care minister Paul Burstow is due to reaffirm the coalition government’s commitment to the personalisation agenda and the further rollout of such budgets to health-service patients and children’s services users.

According to the Financial Management of Personal Budgets, see file at right,  disentangling pooled NHS and social care budgets is “a particular problem” that particularly affects people with mental health needs.

It also warns that some councils will need to make a significant effort to achieve the milestones agreed between the sector and ministers to have at least 30% of eligible social care users on a personal budget by April next year.

While the report cites one unnamed authority that already has 59% of service users on such budgets, others lag far behind.

Joint Local Government Association and Association of Directors of Adult Social Services (ADASS) research in March showed that around 168,000 of some 1.5m potential service users had their own personal budget. The number is believed to have increased since then.

Andy McKeon, the Audit Commission’s managing director for health, said it was clear that some authorities were doing well at offering personal budgets in some services areas but not in others.

“Introducing this radical change in the funding of social care is a challenging, and ongoing, process,” he said.

“Our report gives case studies of councils that are rising to that challenge, and making it work for the benefit of their residents.”

Mr McKeon added that personal budgets were unlikely to save councils money, except in areas where councils had been landed with high-cost care packages as a result of poor commissioning.

“The growth in personal budgets puts block contracts and in-house service provision at risk, as a result of the freedom to choose from different services and providers,” he said.

Association of Directors of Adult Social Services (ADASS) president Richard Jones said he fully expected councils to be offering personal budgets to 30% of eligible service users by April next year.

However, ADASS has long questioned the definition of which service users are eligible for personal budgets, claiming that the government’s measure – National Indicator 130 – includes people for whom such arrangements are not suitable. It believes that just 70% of those defined by the indicator are eligible for personal budgets.

Mr Jones said the association was strongly encouraging councils to work towards the 30% target and fully expected 100%, or 1m eligible service users, to have personal budgets within two years.

He agreed that the Audit Commission report highlighted some of the challenges councils faced including those for people with mental health needs.

“This isn’t just about pooled budgets, but about getting the behaviour change and approach adopted within services that are often integrated in specialist mental health trusts,” he said.

“We fully support the overall direction towards making personal budgets the mainstream approach for all citizens.”

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