SCIE Report 40: Keeping personal budgets personal: learning from the experiences of older people, people with mental health problems and their carers

Key issues

Supply of services

Across all the sites, even those which had a long history of direct payments, individual budgets and personal budgets, there was a strong view that the supply of services was not keeping up with the changing needs and preferences of personal budget holders. This finding is echoed in recent work by the NMDF (09) and in the second report by the University of Kent Personal Social Services Research Unit on the implementation of personal health budgets (10). For those personal budget holders who needed personal care or support to enable them to get out and do things in the community, the employment of personal assistants often transformed their quality of life, but in many areas there were difficulties recruiting such assistants, arranging holiday/sickness cover and/or facilitating training. Even where people were happy to use a care agency, these agencies often did not understand the principles and practice of personal budgets. For personal budget holders with mental health problems in particular there appeared to be much greater scope for people to pool their purchasing power to commission new or different services. Alongside changing their internal systems, local authorities and trusts do need to take a more active role in encouraging the development of provider services, so that personal budget holders have a range of services and support options to choose from.