Right to Control Trailblazer: Legislation and Regulations

This post is one of a series of reflections on the Right to Control Trailblazer work in Essex over the last few months. For an overview of the work, and an introduction to this post, please see the opening post of this series.

The Right to Control Trailblazer learnt from one of the significant problems with the Individual Budget pilots and is looking to ensure there is a solid regulatory basis for the Trailblazers to start from. Indeed, dedicated Regulations for the Trailblazers will be in place before the Trailblazers begin delivery to the public later this year.

One significant challenge is aligning services in which some agencies have statutory obligations (such as adult social care) and others only discretionary choices (such as the Disabled Facilities Grant) – something the Regulations won’t change. The concern here is that the statutory obligation trumps everything else – not just discretionary choices, but also a potentially innovative way of doing things.

It would be my argument that a Trailblazer is, by definition, the place for such innovations to be tested. To this end, any Regulations don’t just have to be restrictive in the sense they limit what can be done. For me, they can also be enabling in order to give local agencies the chance to test if something works better than it does at present.

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Right to Control Trailblazer: Scale and knowing your numbers

This post is one of a series of reflections on the Right to Control Trailblazer work in Essex over the last few months. For an overview of the work, and an introduction to this post, please see the opening post of this series.

Essex is a big local authority area. There are approximately 17,500 new social care assessments each year and there are currently over 33,000 current social care users. All staff in agencies touched by the Right to Control totals around 850 FTEs. The question is thus: how can we role out the Trailblazer on the scale required?

One option is to create a multidisciplinary team that brings together social workers, occupational therapists, Disability Employment Advisers, housing officers etc. and ensure that everyone who accesses the Right to Control comes through this team.

But this approach has its problems: as the Individual Budget pilots of 2005-7 showed, creating small-scale pilots works fine but can often present an unrealistic picture of how to deliver the service and what the underlying challenges are. So the Right to Control could work at a small scale, but as soon as you look to extend it beyond that subset it becomes much harder to deliver.

The alternative is to offer the Right to Control to everyone from day one. But to do this all 850 FTEs across all agencies involved in its delivery will need to have been trained across the 6 funding streams available. The likelihood is that the majority of these FTEs will already be going through significant change in their own agency anyway, so creating this additional (perceived) burden is a significant risk. It’s also probable that each member of staff won’t need all of the knowledge straight away, so double training is a possibility.

For me, the answer lies in knowing the numbers. Yes, it’s true there are 17,500 new social care assessments each year. But there are only 500-600 existing ILF users in Essex (and we know that number isn’t going to grow). Similarly, the numbers of people accessing the other funding streams are relatively low. Thus, at the risk of creating a very complex Venn diagram, ensuring an early understanding of the overlaps of different funding streams, and thus those areas where the Right to Control will really come into its own as it brings together funding streams – the main area of complexity – is absolutely vital.

Doing this will ensure a proportionality to the approach is built in from the very start.

Right to Control Trailblazer update: overview

In my professional life I have spent a considerable proportion of time over the last few months working on the Right to Control Trailblazer in Essex, focusing on service design and reform.

My initial thoughts on the Right to Control Trailblazer, posted after the launch event, can be found here. This post updates those thoughts after 5 months of significant work and progress.

First, an overview. We’re seeking to achieve 3 aims with the Trailblazer.

The first is to ensure that the services and resources a disabled person accesses, and the systems and processes they have to navigate to secure those resources, are organised around the individual. This rather than the more typically found arrangements in which individuals have to fit around service providers, sometimes changing their behaviour to do so.

The second is to ensure that the services an individual accesses are personalised to their requirements, rather than a one-size-fits-all approach.

The third and final aim is, as far as possible, to put choice and control in the hands of the individual instead of the service/professional (the idea of “professionals on tap, not on top”). This includes cash-quantifying a service and working towards giving an individual this cash equivalent amount in lieu of the service to achieve the same results/outcomes. (Such cash payments take the form of Direct Payments in a narrow version of the work, and Personal Budgets in a more ambitious version.)

For the Right to Control we’re working on a subset of services and resources that disabled people access. These go across 3 policy sectors and 6 funding streams as follows: social care (Adult Social Care funding, Independent Living Fund), employment (Access to Work, Work Choice) and housing (Disabled Facilities Grant, Supporting People). These sectors and funding streams touch 6 main types of public agency at local and central government levels: local authorities with social service responsibilities, Job Centres Plus and District / Borough Councils, with input from the Department of Health, the Department for Work and Pensions, and the Office for Disability Issues in a coordinating, facilitative role. The role of my organisation (ecdp) is to provide service user perspectives and ensure the whole process is delivered through the principle and effect of coproduction.

As will all public service design and reform, but particularly that which goes across several different policy sectors, the process so far has been fascinating. As we’ve been going along I’ve been keeping notes across various themes of the challenges and issues we’ve faced. These are shared in a series of posts containing various observations and questions (not all of which have answers). They’re shared in the hope they may be useful for people undertaking other projects, of which I suspect there are more as the public purse realities hit home, or for us to benefit from the knowledge and experience of others. The areas covered are below (I shall include the links after each post is published):

• Scale, and knowing your numbers
• Legislation and Regulations
• Policy ‘versus’ process
• Money, outcomes and money again
• Public agencies working together and the implications for staff

One area of obvious overlap with the Right to Control work is with Total Place. Unfortunately, I don’t know enough of the practical lessons and implications from Total Place so far to usefully draw parallels with the Right to Control Trailblazer work. However, if anyone with that knowledge wants to get together and draw those parallels, I’d love to – please get in touch.

The usual caveat applies to this series of posts: these are personal reflections that should in no way be taken to reflect any official view.

Right to Control Trailblazer launch

I enjoyed attending the launch of the Right to Control Trailblazer yesterday. I attended as a representative of a user-led organisation in Essex – one of eight successful Trailblazer areas.

The Right to Control represents an innovative project that seeks to bring together a whole range of funding streams so that disabled people have more choice and control over how they use the funding they’re eligible for. It’s actually really easy to get into the details of the Right to Control and what it will mean in practice, but much harder to capture the overall shift it represents. The way I characterise it is that, instead of disabled people changing their behaviour and accommodating the way services and funding is provided, the whole thing is shifted around: let’s start (as we so obviously should) with enabling an individual as much possible and configure the services to make sure that happens.

As an approach it clearly has value in and of itself; but it’s one that I think will deliver lessons for a whole range of public services, particularly within the tough budget settlement the public sector will find itself with in 2011/12 onwards.

Alongside many positives, there are many challenges to implementing the Right to Control. For example, getting agencies across the public sector working together – including social care, housing, Job Centres Plus, the Independent Living Fund and user-led organisations – will be tough. There are the system and process changes required to underpin the Right to Control, not least of which is a single or common assessment, as well as the huge complexities of putting all money in one pot whilst still being able to identity outcomes by each agency involved. Ensuring all information, advice and peer support is available is more straightforward, though the delivery of this will require both cultural change within public agencies and appropriate capacity within the voluntary sector. And then, as with everything, there’s the question of political will and senior leadership buy-in.

If these challenges can be overcome – which is precisely what the Right to Control Trailblazers are created to find out (and I think they will work) – then the Right to Control could be a significant success we’ll see replicated across the public sector.

(More information on the Right to Control is available from the Office for Disability Issues and here. Tweets from yesterday’s event are available here.)