Some consensus on the problem, solutions prove harder…

There has been an interesting debate on the LinkedIn group called “The Personalisation Group to revolutionise social care” ( about my last blog entry. I’ve cut and pasted the contributions as comments at the bottom of the last entry.

Martin Routledge (ex DH, now In control and Think Local, Act Personal lead) warned against any suggestion that there was a golden age. I agree that there were of course good reasons for shaking up the system and the RAS was probably the only credible and widely understood approach to managing the money at the time.

Veteran disability rights activist, consultant and trainer, Simon Stevens outlines how his council effectively took a different approach, whilst the RAS is, in his view, ” just itemised billing on an old system”. In a recent comment he says, “A good assessment is a piece of art and not a work of science….It is important to remember, personal budgets were never what was intended, and it was born out of the failure of individualised budgets where the funding streams were supposed to come together……Life is complex and fairness is subjective so assessments must be reflective to individual circumstances. I have heard RAS described as an mechanism to keep social workers ‘on the straight and narrow’ rather than users.”

Colin Strasberg agrees that trying to get to even an estimated cash amount first, before interventions have been properly explored, is the wrong way round. He argues that Fair Access to Care (FACS) eligibility criteria, reviled by many, is actually sound, just poorly developed and applied; it needs developing in Colin’s view to move away from a black and white divide between needs which are eligible for support and those which are ineligible. Colin is working on that idea and it will be interesting to see if he can turn that into a workable route to a personalised system.

Jez Ashdown adds, “My experience of working with a number local authorities across the North of England is that the RAS process has never lived up to its intended purpose… In a system where the resources available fail to meet the need the primary function of that system will be to ration, or allocate resources to competing priorities. In the case of social care this tends to mean that nearly everyone gets less than they need.”

So what we’re all agreed upon is that there are still huge challenges in turning the ideal of choice and control into practical reality, but what we’re short of are detailed, workable alternatives to the RAS…. I’m still drafting my attempt at this – and fully expecting to be shot down in flames when I post it!

Please keep the comments coming…

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