Direct Payments- More Work Needed?

The Scottish Executive has sent out new information on Direct Payments encouraging more people to take some control over their own care planning.  Direct Payments should be seen in a wider context as one form of Self Directed Care.

This is part of a plan to improve health through emphasising self-help and support.  It should also make it easier to get educational and employment opportunities.

The new guidance says local authorities should:
fund local support services to help people prepare early  for assessments and to manage their individual budgets.
support training for people on using self directed support (and also for social work staff)
name special self-directed support lead officers.
Support employment of Personal Assistants by helping with enhanced disclosures and indemnity insurance.

The guidance reminds councils that individual budgets can be used to purchase services from service providers but doesn’t make any special suggestions for helping this process.

Getting this guidance is good.  It shows that the Scottish Executive really wants to make a difference.  However this is the third set of guidance issued to councils and health boards.   The pace of change remains very slow, with actual take up of Direct Payments and other forms of Individual Budgets low.

What’s wrong?
There are many barriers to taking up Direct Payments: lack of knowledge, the difficulty of managing funds and so on.   But sometimes these problems can be managed when it suits the interests of the local authority.

We have heard reports that some councils encourage the take up of Individual Living Fund payments rather than Direct Payments as they bring in new money to the area.   ILF payments usually involve the same challenges as Direct Payments; managing a separate bank account, having a capability to manage funds and so on.

It appears that at least 4 local authorities have much higher than the national average take up of ILF payments while having much lower than average rates of take up of Direct Payments for people with learning disabilities.

Local Authority DP per 10,000 ILF per 10,000
East Renfrew 1.7 11.0
Glasgow 2.1 11.4
North Lanark 0.7 12.0
South Lanark 1.0 11.1
Scotland 3.6 6.5

There are real problems facing local authorities in the costs  of promoting self directed care.  Using Direct Payments ends up saving money in tax and benefits   but costs councils more for extra support services to help individuals manage individual budgets.

We welcomes the guidance being issued as another step towards empowerment.  But the fact that ten years after the legislation was first introduced, guidance is still being issued shows that the good ideas of the Scottish Executive don’t always work out on the ground.  As we have argued in the Alliance there is a need to seriously examine how these policies can be turned into a reality.

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