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Will Government Policies on Self Directed Care Lead to Massive Administration Costs?

At its conference last week entitled ‘Commissioning for Personalisation’, the IOCP learnt that Self Directed Care must have limits and rules. If it didn’t, then the policy would collapse through abuse, lack of fairness and misdirected expenditure. There is a further risk of self inflicted damage through the introduction of massive administration costs.

Self Directed Care is the new Adult Care Policy which encourages user choice in the delivery of care packages signalled by the Government/LGA Concordat ‘Putting People First’ and the Department of Health. This is to be underpinned by effective commissioning and the award of personal budgets.

iMpower made comment that in order to deliver Self Directed Care, considerable culture change would be required supported by workforce development plans and training. The current methods of measuring performance will also have to be modified.

Other speakers said that unless new technology is used to its fullest extent, then administration costs will rise substantially for those using Personal Budgets. Personal Budgets can be made up of Individual Service Funds which are operated through the Council or Direct Payments which is cash provided to Service Users in order to manage their own care.

Where the user decides to use an Individual Service Fund, the following example was outlined. The example used was for 2500 service users making individual and personal choices where as much as £750 pa each could be spent if paper purchase orders were used. At 21%, it’s a considerable overhead on a personal budget of £3500 pa. Training and new technology will have to be used to its fullest extent to reduce these cost levels.

So what else can be done? One option is to try to switch all service users to Direct Payments where they make their own arrangements for care. In a recent study undertaken by Barony Consulting, if one million service users switched to Direct Payments, then with current practice, £400M a year would be gobbled up in processing costs. That is £400 per direct payment holder. And this is on top of any assessment, advocacy, brokerage or agency costs designed to help deliver self directed care.

The challenge for policymakers and Directors is to minimise these and other costs by rationalising existing practices and managing the risks. This will lead to, amongst other changes, the further development of Outcome Based Commissioning techniques. Why should so much cost be used in administration when it should be channelled into Self Directed Care?

As within the NHS, Care Commissioners should be using their expertise to lead change and develop World Class Commissioning standards.


Contact


Doug Forbes

Director, Institute of Commissioning Professionals, 88 Windsor Court, Chase Side, Southgate, London N14 5HA Tel; 020 8886 2462 doug.forbes@commissioning.org.uk

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