The new agenda: Personalisation: Budgets, Processes and Transport Information SystemsAndrew Fish | August 13, 2015
Local Authorities know only too well that legislation changes can necessitate software process changes to their core management information systems. In the UK, government legislation on Personalisation – specifically the introduction of Personal Budgets – is one such change that has the potential to cause wide reaching implications in the way transport is provided in the country.
Indeed, this change has the potential to profoundly affect the way in which social care and transport services are allocated and managed.
This article reviews explores the concept of Personalisation, and considers technology solutions that may be applicable in helping Local Authorities implement this new agenda.
What is Personalisation?
Personalisation means thinking about care and support services in an entirely different way. It means starting with the person as an individual with strengths, preferences and aspirations and putting them at the centre of the process of identifying their needs and making choices about how and when they are supported to live their lives.
Common terms used to describe this approach are “person-centred care” or “self-directed support”. This empowerment process suggests a significant transformation of adult and child social care is required to ensure systems, processes, staff and services are geared up to support the service users.
There are many resources available that describe and define the rules governing personalisation. For example, Age UK have compiled an informative fact sheet, which provides more details about personal budgets and direct payments – explaining what they are and how they work.1
The document succinctly explains how personalisation “has led to a greater choice for people in how their care and support is delivered, but it has also put more responsibility on individuals to manage their own needs. It has led to more arrangements by local authorities with private and voluntary sector organisations to provide a social care ‘market’, and to a rolling back of the involvement of the state. Local authorities provide few services themselves. They [become] commissioners more than providers.”
One important point to make is that the situation in England is not the same for all regions of the UK. As Age UK note: “there are significant differences in how social care for adults and carers works in Northern Ireland, Scotland and Wales.”
A brief history of personalisation
Personalisation is not a new concept; it has been part of government strategy since 2007.
In December 2007, Putting people first (HM Government, 2007) proposed that all social care users should have access to a personal budget, with the intention that they could use it to exercise choice and control to meet their agreed social care outcomes.2 The document suggested this remit would “not require structural changes, but organisations coming together to re-design local systems around the needs of citizens.”
In March 2009, the Association of Directors of Adult Social Services (ADASS) reported that 93,000 people were receiving personal budgets (including direct payments)).3
The initial government expectation was that all 152 councils in England would have made significant steps towards transforming adult social care services, including having at least 30% of eligible adults on a personal budget by 2011, with access to information and advice services to support them (and also to support those using their own money to buy care and support).
A publication in 2013 by the Health and Social Care Information Centre4 reported that the proportion of people using social care who received self-directed support in 2012-13 was 55.6%, up from 43% in 2011-12 and 29% in 2010-11.
In 2012-13, 16.4% of people received self-directed support using direct payments, compared to 13.7% in 2011-12 and 11.7% in 2010-11.
Uptake of Personal Budgets
As uptake of Personal Budgets increased, the UK government planned to move all service users onto Personal Budgets by 2013. However, a new target of 70% of users on these budgets – rather than 100% – was introduced by Care minister, Norman Lamb, in April 2013, following talks with ADASS.5 Yet, while the expectation on uptake has been reduced, there remains a significant government target for uptake, which continues to grow.
Interestingly, the government has also revised the way in which the uptake is measured, with Community Care reporting that “the government would only measure personal budget take-up as a proportion [of] all people who receive long-term support […] previously, it used the wider definition of all users of community-based services.”6
The use of personal budgets has previously been restricted to Adult Social Care; however, this is also changing and authorities now provide support for children with special educational needs (SEN). Examples of authorities implementing personal travel budgets include Newcastle City Council and Kent County Council.7,8
Of course, as with many pieces of government legislation, there has been a mixed reception to its introduction, with arguments made both in support of and against the ‘Personalisation Agenda’.9
For example, in this article published in The Guardian, social care expert Peter Beresford says that “giving people a ‘personal budget’ […] has created an [expensive] distraction” from delivering quality social care, and notes that “Simon Duffy, [who] pioneered the concept of self-directed support and […] encouraged the government to adopt this system [of personal budgets] has recently issued a public apology for it.”
However, Julie Stansfield, chief executive of In Control, argues that “the problem is not personal budgets but rather their poor delivery in too many places”, noting that “too much process and bureaucracy” can prove an impediment to the success of personal budgets and direct payments in shifting “power to people”.10
Personal Budgets – and the Personalisation Agenda as a whole – remains the subject of keen interest. This was evidenced at ATCO 2015, where an informative discussion was held on the topic.
Key points from the ATCO seminar included the note that take-up of Personal Budgets has not been as high as initially expected or targeted, while concerns were also raised about congestion outside schools due to increased traffic as use of private vehicles and taxis increase.
The point was also made that there is as yet no clear cut solution for local authorities in dealing with the spare seats created on buses, as a result of moving passengers to personal budgets. And there is a suggestion that economies of scale may be diminished – meaning it might be cheaper to put everyone on shared vehicles; despite the general trend toward single or private vehicles.
Lynette Mark from Dudley Council gave a detailed and insightful presentation on how the council had approached the provision of transport for SEN children, while also encouraging uptake of personal budgets. She noted that, out of 800 SEN students, 58 children were in receipt of personal budgets.
The Council has looked to increase the uptake of personal budgets by liaising with parents and encouraging them to take control of their child’s transport requirements. The Council also approached some of the perceived risks associated with such a strategy, by asking parents to sign a three-page agreement form.
Indeed, Ms Marks pointed to figures that suggested it was cheaper for parents to arrange taxis for their children directly with taxi companies, because they were able to negotiate better rates with these firms than the local authority would be able to. She also emphasised that, while the Council had embarked on a campaign aimed at promoting use of transport provided by a carer or parent; the most important concern remained and would remain the welfare of the child and family.
Government Legislation and Software Change
Whatever your view on personal budgets, it is impossible to ignore the effect of such legislation on the working practices of Local Authorities – as well as the day-to-day practices of the users and social care workers themselves. In terms of transport, personalisation stands to affect how transport is booked, recorded and audited, as well as how transport budgets are managed and where details, information and important data are stored.
For detailed insight into how people are working with personalisation legislation, Essex County Council released key findings of a research report into the council’s Community Budget Pilot programme, which provided valuable perspectives from the point of view of management, frontline staff and service users.11
One of the key findings was a view shared across management, staff and service users – that a key challenge in day-to-day working, and which also proved an impediment to implementing personal budgets effectively, was that there are too many systems and departments . For example, one frontline worker noted that, even though “we all work [together], our organisations and departments are entirely different […] and we can’t map across [these different silos] because they don’t fit.”
Meanwhile, a public sector manager noted the same issue of “silo working”, explaining that “we need to rationalise and reduce duplication because that’s still there […] there are lots of different [silos] doing different things [and] […] we’re not [working] completely together .” This lack of cohesion appeared to prove an impediment to the uptake of personal budgets; because it made the implementation of new legislative agendas across the organisation more difficult.
At the same time, service users themselves explain they are calling for “one point of contact, one entry point” – rather than a tangle of different silos and systems and departments – a bureaucratic maze they must navigate in order to access the services they need, such as access to transport.
Indeed, writing in the Guardian, a director of adult social care for a local authority noted that workers were being tied “up in bureaucracy”, which prevented authorities from realising “the dream of personalisation […] [meaning] to change our relationships with users and carers, allow people to have real choice about their care, enabling them to stay living at home in their community.” 12
Technology may play a role here; in other areas of Local Authority transport management we are seeing technology as a solution to similar problems, with products such as Trapeze’s Web Worker and the Family Portal (which manages schools transport applications) addressing some of the issues resulting from this ‘silo’ mode of working.
Of course, the introduction of new legislation can necessitate significant software changes and development – as can developments within legislation, such as the revision in uptake parameters and measurement discussed previously.
Therefore, where legislative changes require development and modification of IT solutions, it can prove invaluable to work with a technology provider that is well-versed in such actions and able to easily embed functionality into software as required.
Much of this comes down to software engineering and agility in responding to changes. Indeed, many organisations are now choosing to work with suppliers who can be trusted to not only implement software well in the first place, but to also respond to changes and configure and develop systems in line with these changes.
Adapting to Change
The requirement to adapt software to accommodate legislative changes is not unusual for an organisation like Trapeze. In this section we outline some examples from around the world.
ADA in North American
In North America, the Americans with Disabilities Act of 1990 is a United States Law that prohibits discrimination based on disability. To accommodate this, in the Trapeze PASS workstation software we introduced support for storing ADA codes so that individual bookings can be tracked to ensure compliance against the legislation.
Danish Social Law
In Denmark the social law stipulates that people certified as disabled are allowed up to 104 demand response trips per year. In order to track usage against these quotas, and ensure they are not exceeded, Trapeze software engineers have built eligibility tests into the demand responsive transport management software .
Swedish High Cost Protection
In Sweden there is a government rule called ‘high cost protection’, which means that within a year (floating start/end) a person cannot pay more than a pre-determined amount in fares. This rule is only applied to certain trip types, and therefore cumulative totals must be maintained.
This is managed via special software agent tasks which calculate the cumulative fare amounts and change the fares applicable automatically once the high cost threshold has been reached.
Each of the above examples vary in complexity; yet they demonstrate how software can be adapted to accommodate legislative rules. Without making these software modifications, the transport authorities affected would not be able to operate their management information systems effectively .
Specific Technology Implementations of Personal Budgets
In the UK, the introduction of personalisation legislation has instigated software system changes in a number of local authorities. However, at the time of writing they have had only a minor impact on the software functionality. In some cases, the authority in question has decided that any individual who accepts a personal budget cannot use transport services provided by the local authority and therefore the budget holder’s details falls outside of the scope of the authority’s information capture requirement .
To date, software changes have centred upon the need to track the budget holders transport usage through management reporting. However, with the move to using personal budgets in the domain of school transport, the scope of requirements could well now increase.
Indeed, as one UK Government report – Care and support statutory guidance– noted: “authorities should consider how digital approaches can put citizens in control by making systems open and accessible, including online assessment, care planning, access to records and care accounts.”13
It therefore may not be unreasonable to posit that, in the near future, one key change to local authority software and IT systems might be the introduction of online booking and application portals, as well as the integration of various systems and databases into a single accessible interface.
Some of the resulting technology requirements could be simple; for example, reporting trips which are paid for from an alternative budget source. However, there are more radical alternatives.
A research paper written a few years ago by the Social Care Institute of Excellence states that brokerage is an almost inevitable outcome of direct payment schemes in social care.14
The paper also references some much earlier research by the Joseph Rowntree Foundation (1995) – ‘Increasing user control in social services: the value of the service brokerage model’, which indicates that complete independence from the agencies which fund and which have hitherto provided services has been identified as the essential characteristic of the brokerage model.15
Quite clearly, this has far reaching implications on the role of the local authority in transport provision, not least with respect to the duty of care for the individual being transported.
In the brokerage scenario, independent travel brokers would take ownership of using and allocating the budget and in effect access the services of specialist transport service providers a local authority being one such specialist transport provider. There is at present limited evidence of a shift towards a brokerage model, however, commercial and social factors will no doubt prove influential if large scale take up is adopted. Indeed, as the TSCR noted in one research paper, as more people are given personal budgets, the more likely they are to “want to use an independent broker to hold their money and hence act as the contracting body”.16
One interesting UK Government article noted that “authorities should consider how digital approaches can put citizens in control by making systems open and accessible, including online assessment, care planning, access to records and care accounts.”17 What this comes down to is the role technology can play in enabling both individuals with personal budgets – and the local authorities providing services to these individuals – to work effectively together.
Trapeze provides a number of technology solutions that can assist a transport operation involved in the administration and management of personal budgets. Some examples are described in this section.
Web Worker enables transport requests to be submitted by authorised third party agencies on behalf of one or more individuals. Trip requests are entered via a web portal and submitted to the transport providers’ back office scheduling system, to be actioned by a specialist scheduler.
This article explains how Web Worker puts social workers “in control” of their transport requirements, while also freeing up time for local authority booking staff, who no longer have to deal with time-consuming administrative processes.18
This module is used extensively by social workers to book trips and receive information on the progress of requests. Where third party brokers exist and are taking responsibility for organising transport for individuals who are in receipt of a personal budget, then this module can help to streamline the interface between the organisations.
In instances where an individual in receipt of a personal budget intends to book their own transport requirements, PASS Web can enable them to do so directly with the transport provider via an online portal.
Any trip requests will then appear in the back office scheduling system and, as with Web Worker, are acted upon by a specialist scheduler in the back office.
The system improves the scheduling and dispatch of services, including comprehensive solutions for client registration and journey booking; and integrating with mapping data to ensure accurate trip distances and scheduling.
Indeed, this system has greatly assisted Strathclyde Partnership for Transport (SPT), and has helped underpin the organisation’s MyBus service – part of its innovative Demand Responsive Transport sector. When the organisation installed PASS-Web, MyBus bookings immediately jumped by 361%, and that rise has continued through to this day.19,20
Using Trip Broker module, a booking clerk in the broker organisation can create transport requests and select an appropriate transport provider who can meet the journey requirements of the individual in receipt of the personal budget. The journey is then scheduled to a vehicle associated with the designated provider.
The newly created transport request will then appear within the Trip Broker module, where transport providers can transition the various stages of the booking. Transport requests may also be rescheduled from one provider to another by the broker.
The software allows the bookings to be transitioned through the stages below so that the broker can see the allocation status of each and every transport request. At each stage the broker is able to manage and intervene to ensure the journey is completed appropriately.
- Assigned – Trip is assigned to a provider for review
- Accepted – Trip is scheduled on the provider’s run
- Declined – Trip is not scheduled on the provider’s run
- Updated – Trip is scheduled on the provider’s run
- Unassigned – Trip is not scheduled on any provider’s run
Fully integrated with back office systems, Trip Broker enables third parties to enter the personalisation equation in such a way that may prove invaluable to local authorities – especially if brokerage trends develop as outlined in the TSRC paper mentioned previously.
Community Connect coordinates trip requests between separate transport service providers, which may be required in instances where a single trip request necessitates transport from more than one service or geographical regions, and may involve transfers between those services. This may also prove useful in regard to streamlining and integrating transport networks, which is a key aspect of the government’s ‘Total Transport’ agenda – which seeks to “pool the resources and expertise for local buses with other transport needs like bespoke transport for schools and hospitals”.21,22
Community Connect coordinates transport trips by requesting partial solutions to each portion of the transport from the regional suppliers’ scheduling systems, and then automatically recomposes the potential partial solutions into optimized, complete solutions which are presented in a list ordered by (financial) cost to the Community Connect user.
Once a final solution is negotiated between the requester and the call-taker, a synchronization process ensures all affected transport suppliers are notified of the final trip details. The Community Connect Interface allows for the exchange of data with its external transport suppliers software systems through a uniform web-based protocol.
Perhaps key to the system is the way it centrally stores information – streamlining databases and processes and providing a single solution to managing data. This is potentially crucial in helping avoid instances of silo working and overcoming the impediments of bureaucracy and multiple systems and process, which were outlined earlier in the document.
Another crucial aspect is the way it can help transport authorities integrate multiple transport networks. For example, using non-emergency PTS vehicles, as well as SEN vehicles and those vehicles designed to support adult social care, for integrated cross purposes.
A brave new world
Uptake of personal budgets is on the increase, representing a significant shift in the way public money is allocated to deal with social care and local authority transport provision. This can be seen as part of a wider trend towards greater flexibility over the way public finances are allocated (see also Community Budgets) and accessed.23
Looking to the future, it is possible that the increased use of Smart Technology , particularly Smart Ticketing – for example to allow central coordination of trip costs – could be used by organisations to better track and manage personal budgets.
Smart technology could be used in the tracking of trip volumes, for example, or to monitor utilisation of trip budgets. However, there may be some work required for transport operators to effectively integrate technology with their vehicles, perhaps via an effective interface, such as an NFC link, for example.
It may be the case that the best way to incentivise passengers to track their own budgets is by offering them high-quality smartphone apps, which can do this for them. Such tools may prove an effective way of encouraging people to take up a personal budget.
The use of mobile tickets, smart cards and the uptake of smartphone apps to support budget usage is certainly something to monitor, and Trapeze will continue to do so – in order to remain best placed to help organisations adapt to any necessary system or process changes.
Personal Budgets and the personalisation agenda can seem a brave – and potentially frightening – new world. For example, the Essex report on the community budget pilot noted “some concern among [service users and frontline workers] that this [community budgeting] was just another way of cutting budgets behind a string of grandiose words.”
However, such legislation and policy changes need not be viewed in this light. There are legitimate concerns that these developments can necessitate potentially wholescale changes within organisations, including to IT systems of software services, but such concerns can be assuaged by working with third-party suppliers of these systems who are able to offer support throughout any systemic change and who have previous experience of helping organisations do just that.
- “Personal budgets and direct payments in adult social care” Age UK (April 2015).
- “Putting People First: A shared vision and commitment to the transformation of adult social care” HM Government (2007)
- “Councils meets 30 per cent target for personal budgets” Think local act personal (2011). http://www.thinklocalactpersonal.org.uk/News/PersonalisationNewsItem/?cid=8981
- “Measures from the adult social care outcomes framework, England” Health & Social Care Information Centre (10 July 2013)
- SAMUEL, M., “Lamb scraps 100% personal budgets target” Community Care (October 26, 2012) http://www.communitycare.co.uk/2012/10/26/lamb-scraps-100-personal-budgets-target
- STOTHART, C., “Government to change controversial indicator on person budgets take-up” Community Care (June 23, 2014) http://www.communitycare.co.uk/2014/06/23/government-change-controversial-indicator-personal-budgets-take/
- “Personal Travel Budget (PTB) for children with additional needs” Newcastle City Council http://www.newcastle.gov.uk/education-and-learning/benefits-and-educational-grants/personal-travel-budget-ptb-for-children-with-additional-needs
- “Personal Transport Budgets” Kent County Council http://www.kent.gov.uk/roads-and-travel/school-transport/school-transport-for-children-with-special-educational-needs/personal-transport-budgets
- “Personalisation for providers” Personalisation Agenda http://www.personalisationagenda.org.uk/
- BERESFORD, P. and STANSFIELD, J., “Are social care personal budgets working?” The Guardian (February 2013) http://www.theguardian.com/society/2013/feb/12/are-social-care-personal-budgets-working
- “Community Budget Pilot: Initial Qualitative Research – key findings from focus groups” Compiled for Essex County Council by Qaresearch (23 February 2012).
- Personalisation is bogging us down. Whatever happened to social work? The Guardian (December 2011) http://www.theguardian.com/social-care-network/2011/dec/19/personalisation-bogging-us-down-social?intcmp=239
- “Care and support statutory guidance” Department of Health (2014), https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/315993/Care-Act-Guidance.pdf
- “Research briefing 20: the implementation of individual budget schemes in adult social care” SCIE. http://www.scie.org.uk/publications/briefings/briefing20/
- “Increasing user control in social services: the value of the service brokerage model” Joseph Rowntree Foundation (1995) http://www.jrf.org.uk/publications/increasing-user-control-social-services-value-service-brokerage-model
- DICKINSON, H., and GLASBY., J., “The personalisation agenda: implications for the third sector” Third Sector Research Sector (TSRC) (February 2010).
- Care and Support Statutory Guidance https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/315993/Care-Act-Guidance.pdf
- FISH, A., “Are social workers the secret weapon for local authority transport?” http://www.trapezegroup.co.uk/article/social-workers-the-secret-weapon-for-local-authority-transport Trapeze (March 2015).
- Trapeze Team “Joining Up Journeys with SPT” http://www.trapezegroup.co.uk/case_study/joining-up-journeys-with-spt
- Trapeze Team “Trapeze and SPT Achieve Huge MyBud Online Booking Growth” http://www.prlog.org/12054340-trapeze-and-spt-achieve-huge-mybus-online-booking-growth.html
- “Total Transport: Working across sectors to achieve better outcomes” PTEG (June 2011) http://www.pteg.net/system/files/20110627ptegTotalTransportforWebFINAL.pdf
- BROWNE, D., “DfT launches fund for local ‘total transport’ trials” Surveyor Transport Network http://www.transport-network.co.uk/DfT-launches-fund-for-local-total-transport-trials/11284 (January 2015)
- “ Community Budgets” GOV.UK https://www.gov.uk/government/publications/2010-to-2015-government-policy-local-government-spending/2010-to-2015-government-policy-local-government-spending#appendix-1-community-budgets