Services for people of any age and in any number of situations, who require additional support in their daily life, are challenged by reducing budgets and ever increasing demands for support.
Integration, if person centred in foundation, has the potential to deliver a transformed offer of support and access to people of any age. There are major risks though, and much should be learned from the roll-out of personal budgets. What started with creativity, flexibility and exciting changes for people in how they lived and experienced, support became more difficult as the focus shifted to systems and process i.e. as the focus shifted from being person-centred to system change. On top of this, there is the likelihood that it will be seen as a further opportunity to cut costs; whilst there may be efficiencies in a simpler and ‘whole life’ focused offer of support this cannot be the primary driver.
For us at In Control and many others, integration around the person provides an opportunity to tackle silos of need, arguments about funding and territories being fought over. More though, it provides opportunity to think again about how support is provided and what it focuses on; we would explain this as a combination of investing in the real wealth of individuals and resilience, and investment in community wealth and inclusion. Strategies and work to transform the public offer of support need to centre on how to support people to develop their real wealth; their skills and knowledge, their personal and social networks of support, their assets. Those same strategies will also need to be centred on developing the wealth and inclusivity of local communities of all forms; how buildings can be more accessible, how people can be more welcoming and respectful, how community assets can be used for the benefit of all.
‘A life not a service’ sets out an approach to integration that centres on the individual, those closest to them and local communities. This guide with its accompanying briefings (Briefing one, explaining the thinking in more detail and Briefing two, which thinks about this approach with regard to Mohammed Aaqil and his family) explains what we mean by real wealth and community wealth, and restates using (with permission) Heather Simmons’ graphic about Values / Approach and Mechanics the importance that all this work retains it focus on values and improving the lives of people.
As important as it will be to maintain a person centred approach to all parts of an new integrated offer it is essential that the foundation for all this work is a set of values, for example; inclusion, transparency, honesty, simplicity. As stated, we are all too aware of what happens when the focus shifts from people and a simple set of values to approaches dominated by complexity, paperwork, risk aversion and the misguided thinking that constraining creativity and flexibility will cut costs.
An integrated offer, with clear eligibility, accessible information, support from a named person, upfront indicative allocations of support and funding, creative and flexible solution finding, building on strengths, focusing on outcomes and not needs, with a family and whole life focus….all this is possible. There are examples across this country and others where, on a small scale such approaches have been put in place, where values of transparency and simplicity are clearly visible in the support offered to people. The challenge is to maintain the values base, to maintain and strengthen the person-centred approach to integration and the new system and not to miss the potential which so many people want to see realised.
Children, young people, families, adults, older people: all are people, all are whole; our offer of support has to centre on this fact, offer support that invests in people’s real wealth and the wealth of their local community.
Further information on the reports, future publications and how you can get involved is available here.