Report 37: Personalisation, productivity and efficiency

Preventing admissions

'The use of personalisation and 'community-based approaches' can result in crisis prevention and avoiding admission to hospital or residential care' (21)

Personalised and 'low level' community-based approaches to integrated adult social care and support can result in crisis prevention and avoiding admission to hospital or residential care, particularly for older people. (21, 22, 23) This can result in improvements to productivity in adult social care. The way people use personal budgets can be preventative, particularly in mental health, (24, 25) thereby reducing health crises or hospital admissions that can result in savings to health. However, cost savings to health are not necessarily registered by or shared with local authorities. (26, 14, 27)

The following extract from 'SCIE Research briefing 20: The implementation of Individual Budget schemes in adult social care' (27) makes some key points on savings gained by health from some of the research up until 2008 (this also includes research on direct payments):

What research indicates is that personal budget schemes from social care funding may have the potential to produce savings for health, but that it can be challenging for social care to achieve the flexibility with health funding necessary to meet the support needs of individuals, particularly Continuing Healthcare for those with complex needs. If this is the case, action may be needed to ensure that funding structures and budgets reflect this dynamic. Central government may have a strategic role to play here.

The IBSEN study, the In Control evaluation and the Commission for Social Care Inspection have revealed that there were significant challenges in aligning and integrating funding streams within existing regulatory frameworks. Particular barriers were identified for NHS funding. This is found to impact especially on people with mental health problems and may also have implications for older people. In Control reported that 'a disparity of funding levels [between health and social care] …prevented three people [with learning disabilities living in a hospital setting] from moving into the community'. (27)


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