Report 37: Personalisation, productivity and efficiency
'Done thoroughly and systematically, self-directed support is less wasteful than traditional systems...it targets money more effectively and directly to citizens and communities where it can have most effect.' (3)
A local authority survey of the cost-efficient implementation of direct payments by the Audit Commission in 2006 concluded that where direct payments are properly introduced, they can produce higher-quality and more efficient services. However, when choice is not implemented efficiently, this adds to costs and reduces value for money.
This finding is reflected in emerging evidence on the transformation of business processes to implement self-directed support and personal budgets. However, much of the reform work has been supported by the Social Care Transformation Grant, for which there were no audit requirements. An ADASS and LGA survey of local authorities showed that in the first year the Grant was spent on changes to care management, internal process development and dedicated project teams (4).
The Care Services Efficiency Delivery (CSED) programme identified process improvement as vital for efficiency, service quality and staff satisfaction (5).
Evidence suggests that local authority business processes are becoming more efficient in the following areas:
- Access management: streamlining processes, providing a single point of access, developing a single dedicated access team across adults services
- Proportionate auditing of direct payments: introducing 'lighter touch' processes which allow qualified frontline practitioners to spend more time working with the person using the service and fewer resources spent on administration
- Improved use of IT systems: using integrated IT systems for assessment and personal budget processes, web-based commissioning and use of e-commerce.
It seems that the personalisation agenda is stimulating review and change in business processes. This appears to have reliable potential to generate efficiency savings and improve productivity.
Case study: Corporate risk management and direct paymentsOpen
Lincolnshire employed a corporate risk management approach to support the development of a simplified, flexible approach to direct payments. Inaccurate perception of risk of fraud and misallocation had resulted in 'an unworkable system' which resulted in 'staff resources [being] spent carrying out audits and attempting to resolve the issues raised by them' (6). Following a review of the system, the key process changes and improvements were made:
- … new direct payments team to bring together an improved operational and development capability
- replacing the cumbersome audit process with a lighter touch, proportionate finance check
- reducing the frequency of checks by 95 per cent (down from quarterly checks on 100 per cent of individuals to annual checks on 10 per cent)
- allowing all parties to request a finance check if concerned
- introducing an annual, simple, bank balance check on 100 per cent of individuals
- creating a tool to calculate amounts of direct payments and generating the required forms populated with the necessary data. (6)
As a result of the introduction of the new system resulting from the corporate risk management consultation exercise, the Council reports that in the following financial year:
… cashable savings of £130,000 were made. In addition, over £77,000 noncashable savings were achieved, calculated from the estimated time saved by care managers not having to waste time following up high volumes of unhelpful audit reports. (6)