Direct payments allow people to arrange their own social services. They give individuals control over the social care funding to which they are eligible, and are seen as an important vehicle for promoting independence and choice. Yet a new report out today, Wednesday 8 August, reveals substantial variation in direct payment arrangements.
The report, Direct Payments: a national survey of direct payments policy and practice, is published by the Personal Social Services Research Unit (PSSRU) at the London School of Economics and Political Science on behalf of a consortium of research teams.
The UK-wide survey suggests that direct payments packages are provided to people receiving more hours of care per week than the average social care recipient. Significant disparities between local councils were found in the proportions of eligible people receiving direct payments as well as in hourly payment rates, which may affect how individuals attain a fair stake in the market for social care.
Direct payments continue to be provided most commonly to people with a physical disability or sensory impairment and least often to mental health service users. But further disparities are also revealed. Typical prices of the care that needs to be purchased vary widely between user groups, while direct payment rates are largely identical. For some user groups, the payment rates received are substantially lower than average prices for home care, which inevitably limits choice.
Professor Martin Knapp, one of the report's authors, said: 'Despite the striking growth in the take-up of direct payments over the last ten years, the varied implementation across the UK and between service user groups raises questions about social justice for people supported by social care services.'
Three factors particularly appear to hinder progress:
concern among service users and carers about managing direct payments
staff resistance to direct payments, and
difficulties finding enough people to work as personal assistants.
The report raises concerns over the funding of external support for people with direct payments. There is a growing consensus that social care users do not automatically achieve independence and choice simply by being given their own funds to buy services: structured support is also needed by many people. Yet there are very wide variations across the UK in the funding of support services. Indeed, the research found an 11 per cent drop in local authority funding of support services during the two years covered by the survey.
Hailed as fundamental to the future of social care in the next decade and beyond, there have been repeated calls for local councils to move direct payments into the mainstream. Yet, in March 2006, ten years after their introduction, less than 42,000 of the approximately one million people eligible to receive a direct payment did so.
The Direct Payments Survey was coordinated by the PSSRU on behalf of three multidisciplinary research teams, funded by the Department of Health, the Economic and Social Research Council and the Modernisation of Adult Social Care Initiative.
The full report and the executive summary are available to download at http://www.pssru.ac.uk/dps.htm
Jose-Luis Fernandez, 020 7955 6160, email: firstname.lastname@example.org
Martin Knapp, email: email@example.com
8 August 2007
Guardian (8 August)
We must win hearts on direct payments
Article about research out today on direct payments, written by Professor Martin Knapp, one of the report's authors. Martin Knapp is professor of social policy and co-director, LSE Health and Social Care at LSE.