Direct payments: Answering frequently asked questions

Question 04. How will direct payments improve things?

It is clear that direct payments require a change in culture for staff in local authorities. It requires a shift in power and more emphasis on applying resources to need rather than need to existing services.

It is a move from being the gatekeepers of services to providing the type of support that people actually want and from which they can benefit.

This can lead to a dramatic increase in job satisfaction and the knowledge that, as a care manager, you have been able to work in collaboration with service users to make a difference to how they lead their lives.

Of course, not all service users will want to take up direct payments. Some will be content with the services they receive and not want anything to change.

However, one of the main reasons for the change is that it has been recognised that existing services are not suitable to fulfil everyone's needs, and there is clearly mileage in giving people choice and flexibility.

Direct payments offer greater independence and flexibility in support arrangements, and for people from black and minority ethnic communities, this can mean improved access to culturally sensitive support. For people experiencing mental health problems, direct payments can facilitate social inclusion, through providing support to access mainstream activities that are not stigmatising or mental health focused. (4)

I wanted people who looked at me and talked to me, treated me like a human being. The agency that provided my services before direct payments kept sending me people and I kept rejecting them, so when I heard about direct payments and being able to choose my workers, it seemed like a positive choice to move from any old crap that they wanted to send me to having somebody I felt comfortable with.

Direct payments service user

What's being asked of you is not easy, I know that. It means a change in approach. It means going much further in treating the people you work with as individuals and tailoring support around them. It means letting them be in charge. And it means really signing up to the principles of independent living, and helping people move away from being dependent on you for help to being dependent only on themselves. That's no small task!

Speech by Dr Stephen Ladyman, former Minister for Community, Department of Health, 18 May 2004

Nobody promotes direct payments (DPs) better than the people using them. This became clear to me when I was working in a physical disabilities social work team and was meeting disabled people every day who were describing what a difference DPs had made to their lives and how it had given them more control. I now do training with social workers and my co-trainer is disabled and a DP user with a PA, and this also promotes DPs in a very positive way. We hope to use this approach in promoting DPs to older people by encouraging a DP user in this field to share their experience with people their own age. We have a new worker we hope can follow up on this.

Coventry LA

Two-and-a-half years ago when we relaunched the direct payments scheme, I visited all the care managers in all the teams and did a presentation on direct payments, what the concept was all about and the long-term benefits for the service users. As a result, there were a few social workers who became very keen to introduce this into their work, they understood the potential benefits, were very supportive and believed DPs were a good way forward for all. When they had set up some schemes, there was discussion of the cases within the local team and they were able to pass on their positive thoughts and beliefs to other team members and colleagues. They also worked closely with the DP champions. Peer support, word of mouth was a very good way of educating other team members.

Hounslow LA