Rethinking the role of commissioning: moving beyond direct payments

February 14, 2018

A new report focusing on moving beyond direct payments and rethinking the role of commissioning has been co-authored by Dr Simon Duffy of the Centre for Welfare Reform and Angela Catley of Community Catalysts and published by Think Local, Act Personal.

The report says that direct payments were intended to help people have choices and offer flexibility with how they manage their support. The reality is that for many, the extra work involved with having a direct payment does not make them an attractive or easy option and people who receive direct payments can experience them as a burden. It states that there are alternative ways for local authorities to commission support that go beyond such ‘limitations’.

In Beyond Direct Payments: making the case for micro-enterprise, Individual Service Funds and new forms of commissioning in health and social care, the authors discuss ways of commissioning support that are a homage to the early days of personalisation with its focus on community and traditional social work practice, and that give people the chance to get flexible support.

Micro-enterprises like those nurtured by Community Catalysts; Local Area Coordination; Social Prescription and the take up of Individual Service Funds are all cited as valuable examples. The authors argue that managers working in health and social care could support and promote these types of commissioning if they are to help create a more diverse market to support people should a direct payment not be the preferred option.

The authors said, 'Personalisation was never meant to be about just spending a budget; instead it was supposed to focus on building on people’s gifts, talents and desires not on professional conceptions of ‘need’– and on outcomes that strengthen the spirit and resilience of the person and their family…'

Christopher Watson, Joint Commissioning Manager at Dorset County Council, said, 'In practice Individual Service Funds allow a far greater degree of choice and flexibility than traditional commissioned services and, in some ways, they can be easier to manage with less administration than Direct Payments,

'In Dorset, we have already seen the Individual Service Fund approach deliver real and tangible benefits for people by helping them to understand their personal budget, which can give them and their chosen provider the flexibility to co-design how their outcomes are best met. Other organisations can deliver elements of support and there is the opportunity to pool some or all the funding with friends, who may be supported by other providers, but have similar identified outcomes.'


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