Report 37: Personalisation, productivity and efficiency

Conclusion

'Self-directed support and personal budgets could lead to improved outcomes in individual cases for the same cost if implemented efficiently and effectively'.

It is too early, and there is not enough robust data available, to make conclusive evidence-based decisions on whether or how personalisation (specifically self-directed support, personal budgets and direct payments) has delivered efficiency savings, reduced costs and improved productivity in adult social care. Longer-term research and evaluation needs to be undertaken in this area.

Despite this, there is some evidence to suggest that self-directed support and personal budgets could lead to improved outcomes in individual cases for the same cost if implemented efficiently and effectively. So:

'it is essential for councils to check that personal budgets are authentic – that they are actually resulting in greater choice and control for individuals'. (37)

Local authorities need to monitor the costs and outcomes of personal budgets.

There is increasing evidence from the independent (voluntary and private) provider sector and from micro services that local authority commissioning practice needs to change in order to foster efficiency and productivity. It appears that adult social care commissioning is not yet creating the type of market development, diversification and community capacity building needed for personal budgets to be used productively and efficiently.

Personalised approaches to integrated health and adult social care and support can promote both primary and secondary prevention. The evidence that investment in prevention can generate savings is probably clearer than that presently associated with personal budgets and self-directed support.

Most notably, the personalisation agenda is stimulating review and change in business processes, administrative and management systems. The evidence so far shows that this appears to have reliable potential to generate efficiency savings and improve productivity in certain areas.

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