03.03.16
DH must improve understanding of personalised social care – NAO
More must be done by the Department of Health to improve its understanding of the benefits of personalised commissioning in adult social care and how it should be implemented, a new National Audit Office (NAO) report says.
The NAO report noted that pilots from 2009-12 found that personal care budgets led to improved quality of life for patients and were cost-effective, although they did not lead to improved health. However, the NAO warned that this evidence is now out of date and recommended further research, saying that the department’s monitoring regime does not enable it to understand how personal budgets improve outcomes because its indicators measure take-up rather than user outcomes.
Under the Care Act, personal budgets were made mandatory for all eligible users from April 2015. In 2014-15, 500,000 adults in England had social care paid for through local authority personal budgets, and councils invested £6.3bn in long-term community care.
Amyas Morse, head of the NAO, said: “Giving users more choice and control over their care through personal budgets and direct payments can improve their quality of life, but much of the positive evidence for personalised commissioning of adult care services is old.
“The Department now needs to gain a better understanding of the different ways to commission personalised services for users, and how these lead to improvements in user outcomes.”
The report also found a conflict between the expectations of local authorities and the department, with 84% of directors of adult social services saying they expected personalisation to save money in 2016-17, whereas the department said that they did not expect it to save money.
Overall, the NAO recommended that the department should improve its understanding of the relationship between the different ways to commission personalised services for users, and improvements in user outcomes, understand how councils intend to make savings, and support national initiatives to support the supply of care workers.
A Department of Health spokesperson said: “Personalised commissioning can improve people’s quality of life and experience of care by involving them in planning their care and giving them more choice, control and flexibility. Through the Care Act, we have put personalisation at the heart of care and support so that people can choose the options best suited to their needs.
“We take very seriously our responsibility to understand system-wide pressures and the impact of personalised commissioning. We will consider the NAO’s report carefully.”