Report 37: Personalisation, productivity and efficiency
'When people manage their own support planning or go to external agencies this is at least theoretically less demand on care managers' time ...' (17)
External support planning and brokerage, particularly services provided by user-led organisations and centres for independent living, are regarded as a crucial element for the effective implementation of self-directed support and personal budgets. Access to external support planning and brokerage is important for putting personal budgets into operation for people who may not be confident or have support from family and friends. (18)
A Welsh study of two Independent Living Support (direct payments plus support from a user-led organisation) schemes showed that for disabled people, a reduction in overheads for the local authority could be achieved for information sharing, training and ongoing user support (7). Findings from the IBSEN study showed that future efficiencies could possibly be realised:
'when people manage their own support planning or go to external agencies this is at least theoretically less demand on care managers' time ... this might therefore provide an opportunity to use existing resources to support a wider group of people or to provide more tailored support in preventative activities or high-risk situations' (17).
CSED research shows that councils can achieve efficiencies in the brokerage process – for example, by separating the frontline activity of qualified social workers from office-based administrative care placement activity. They estimated that a brokerage team of non-social work staff to resource care plans and manage contracts could result in savings of up to £291,000 (19).
Further key points were:
- Specially trained staff are more productive than care managers in managing
provider bookings and updates to the care record system and finance. This
frees up care managers' time and can also result in:
- speedier initiation of care
- increased data accuracy; reduced finance queries.
- There are potential salary savings based on the increased productivity of brokers, and these benefits are enhanced if they are paid on a lower scale than care managers. In addition, brokers can exert downward pressure on prices, avoid charges from delayed discharge and reduce voids (so that each place is offset by income and, over time, the number of block places may even reduce).
- Further savings may come from process/technology improvements (such as web-based commissioning).
- The impact of Direct Payments/Personal Budgets on the care market is likely to be significant, and brokerage can play a key role in managing the changes. (19)