Personalisation is critical to the changes we need to see in our care and support system. At the centre of my vision for personalisation are two important principles, that we should build a system that promotes people’s independence and wellbeing and that people should have control of their care and support and be able to make the choices that are right for them. Fundamentally, good care should mean care that is built around the whole person, their skills, aspirations and preferences as well as their needs. Good care should also extend the opportunity for independence and help to build stronger community links, not just for the few, but for everybody. This is why I have ensured that personalisation is at the heart of the Care Bill, the biggest change to the legal framework for care and support in England for more than 60 years. From the principle of wellbeing that underpins the reforms, to placing personal budgets on a statutory footing for people with support needs and carers for the first time, through to the new duties around information, advice, advocacy and market shaping – all of this is designed to set the context for making personalisation a reality.
This is why I called a Summit on personalisation in September, facilitated by Think Local Act Personal, to take stock of progress and redouble our efforts to get it right. I know that there has been some good progress. There are many more people receiving personal budgets now than when I came into office and the outcomes are reportedly better, and some places have made great strides in shifting the emphasis of care away from managing deficiency, towards prevention and enabling people to live better lives. But I also know that there is so much left to do. I hear about restrictive practices that limit choice, of people whose dignity is compromised in their own homes or in care homes because of poor care, of the limited progress that has been made with personalisation in mental health and of a cliff edge between care and health for people whose needs cross both. This has to change. We must refocus as the Care Bill approaches on making genuine personalisation the norm, in all settings and for all people, all of the time.
Another of my priorities is integration – person-centred, coordinated care – and I have personally seen to it that there is now a focus on making progress with this critical reform at pace and scale. Both through the announcement of the Pioneers in November and, along with my colleagues in government, provision for the Better Care Fund, which will help to redirect resources towards community based care and support and protect vital NHS services. But integration and personalisation are two sides of the same coin, it shouldn’t be one or the other, and the current context presents a huge opportunity. By bringing our health and care systems closer together we can ensure that with integration, comes personalisation. So that people can expect the same focus on their independence, the same regard for their wishes and the same opportunities to make choices and to take control, whether they have a long term health condition or a social care need, a mental health problem or a learning disability. This is why I say that people themselves are the best integrators of their care. It is personalisation that will make this possible; including the use of personal health budgets, which I have ensured will be available with a “right to have” for everyone with NHS Continuing Care needs from October of this year.
In the midst of all this, there were some very clear messages from the personalisation summit about the things that need to happen to take personalisation forward. I am delighted that TLAP have led the work with partners published today, which provides a roadmap for personalisation in advance of the Bill. I will also write to councils about this and to bring several things in particular to their attention.
Firstly, to encourage them to sign up to Making it Real, TLAP’s markers of progress, developed by people using care and support services, carers and family members, which set out what personalisation looks and feels like when it is working well in their own words. I have been impressed by the ways some councils, and many other organisations across the sector, have used Making it Real to build strong momentum for personalisation locally, and I want this to be a universal experience.
Secondly, The summit emphasised for me how important it is to focus on the outcomes from personal budgets, not just the numbers. Are people getting better lives and support and is the experience simpler and more flexible? This should be checked with people and families directly. One way of doing this is to use the Personal Budgets Outcomes Evaluation Tool (POET). I am really pleased to say that over the next year all councils who wish to use this tool will be able to do so and I would encourage all to do so.
But above and beyond this, I want to conclude by renewing my commitment today to supporting the sector to see this vital work through by contributing this blog as part of TLAP’s work to create a new Partnership Agreement and by confirming Government’s ongoing support for the Partnership as it moves into its next phase from April 2014.
