Through my representative roles with Shared Lives Plus and now Community Catalysts (both TLAP partners) I was involved in the development of Making it Real from the beginning. I thought then, and continue to think now, that this is one of the most important pieces of work undertaken by TLAP, or more specifically TLAP’s National Co-production Advisory Group (NCAG).
Making it Real brought a set of national standards for care services which had been developed by people using those services and their families. They focused on what was really important to people and recognised that ‘services’ are there to help people live the lives they want, so should naturally fit around people and not the other way round. They were written as ‘I-statements’, which helped underline people’s expectation that services and supports would be shaped around their requirements and let them get on with life.
They were published in 2012 at a point when personalisation, and personal budgets as a tool to deliver personalised support and services, had been embedded in government strategy and was being implemented in local authorities across England. They provided an important challenge to local authorities and providers implementing personalisation to make it real and it was encouraging to see how many signed up and published action plans for delivering personalisation in practice. There was an early community of practice which provided mutual challenge as well as encouragement, and practices which did not give people real choice and control were contested. Over the years the movement grew and influenced the practice of many providers and local authorities.
The growing pressure on public finances, beginning in 2010, meant that local authorities had to find ways to make a shrinking pot of money meet the needs of people growing in numbers and complexity of need. Many local authorities and providers rose heroically to the challenge but despite the creativity of their solutions, all were forced to make increasingly difficult decisions about who could be supported and how much money could be made available to support them. There was a new emphasis on helping people draw upon their own assets and the assets of their communities, mirrored in the Care Act and the National Health Service England (NHSE) Five Year Forward Vision. With this new focus came an apparent drift of attention away from personalisation and helping people to take control of their lives and services, despite continuing government rhetoric around the importance of personal budgets and health budgets. For too many people, personal budgets remain illusory, providing limited or no choice of support and services, and so no more control over their lives.
In this context the renewal and relaunch of Making it Real is vitally important, posing a new challenge to current local authority and provider members to make personalisation real. As important, though, is the work being done to ensure that the standards work for health as well as social care. People with continuing health conditions have an equally urgent right to genuine choice and control of support and services as those who need a social care service.
