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Citizenship &

Self-direction
exploring good practice
1. The wider context is important
2. Citizenship, not choice, is the goal
3. It’s not budgets, it’s entitlements
4. Flexible support, not brokerage, is critical
5. Collaboration and innovation, not purism
1. Context
The welfare state was
created to tackle real
problems, but
sometimes created
new problems…
Citizenship & Self-Direction - exploring good practice.
• The growth in the economic cost of
health and social services is an
international problem.
• More expensive, more centralised
and more institutional services grow
in cost, but do not become more
efficient.
• Greater value lies in supporting
citizenship, families and local
communities, but investment in this
is reducing.
• How can we move resources
upstream to solve problems earlier
and more efficiently?
An international challenge
€
£$
Citizenship & Self-Direction - exploring good practice.
• Personal budgets offer one
powerful way of moving
resources out of the wrong
services and back to citizens
and local communities.
• Personal budgets are flexible
and they let people be creative
and use resources in their
local community.
• Personal budgets help
community organisations to
get funding from people -
outside the procurement
systems that often leads to
centralisation.
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
Self-directed support has been growing for 50 years
• Personal budgets are not the solution for
every problem
• The need for self-directed support will reduce
in fairer and more inclusive communities
• Some services are better organised by
collective or professional decision-making
2. Citizenship
Value of self-direction is
• not about consumer
choice
• not just about meeting
needs
• not just human rights
• about meaning & love
Agency for citizens means control and cooperation
consumerism is a minimal form of agency
Citizenship & Self-Direction - exploring good practice.
1. Finding our sense of purpose
2. Having the freedom to pursue it
3. Having enough money to be free
4. Having a home where we belong
5. Getting help from other people
6. Making life in community
7. Finding, sharing and giving love
Citizenship = different and equal
Human flourishing
requires a sense of
meaning and love
Citizenship & Self-Direction - exploring good practice.
• Self-direction is about meaning, the human
spirit and love
• The success of any system or innovation
should be tested by those realities
• If our work is not fulfilling for ourselves then
we are not doing the right work
3. Entitlements
People take control and so can become full
citizens playing and active part in community life
If budgets can be used flexibly then people use money differently and
connect to community
Location N Change
England - 6 Sites Phase I Report 60 -18.0%
England - 17 Sites Phase II Report 128 -9.0%
England - 13 Sites IBSEN Report 203 -6.0%
England - Northamptonshire 17 -18.7%
England - City of London 10 -30.0%
England - Worcestershire 73 -17.0%
England - Southwark 85 -29.8%
Scotland - Glasgow 12 -44.0%
USA - Denver - Disabled Children - -34.0%
USA - Florida - Disabled Children - -30.0%
Citizenship & Self-Direction - exploring good practice.
4 strategies to ensure efficiency
1. Transform how existing funding is
used - don’t spend new money
while leaving the old system in
place.
2. Make sure there is funding in place
to make rights real - delegate
money to local areas as much as
possible.
3. Don’t restrict too much who can
provide support or help people
manage their budgets - keep the
system open.
4. Make sure people can use money
flexibly, so that they can build on
what is already good in their life.
• Transparency and clear rights convert
resources into meaningful entitlements
• Entitlements enable the agency of the citizen
• Eroding entitlements is to weaken the
effective citizenship of the person
4. Support
We’ve not paid
enough attention to
personalised support
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
Citizenship & Self-Direction - exploring good practice.
• Too often independent
brokerage is treated as an
inevitable requirement of any
system of self-directed
support
• This underestimates what
people and families can do
• It underestimates the positive
role social workers can play
• and the positive role of good
personalised support.
Citizenship & Self-Direction - exploring good practice.
• Relationships matter, including relationships
with professionals
• Social workers, support providers and others
need to join the journey towards self-direction
• Let’s avoid adding to the complexity of the
system - where we can.
5. Innovation
Citizenship & Self-Direction - exploring good practice.
• The system fights back - that’s why it’s taken
50 years just to get to here
• Competition isn’t helping drive forward
innovation
• It’s time to refocus on the goal and work
together
Citizenship & Self-Direction - exploring good practice.
www.cforwr.org
@citizen_network

@CforWR 

@simonjduffy
fb.me/centreforwelfarereform
fb.me/citizennetwork
e simon@centreforwelfarereform.org
www.citizen-network.org

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Citizenship & Self-Direction - exploring good practice.

  • 2. 1. The wider context is important 2. Citizenship, not choice, is the goal 3. It’s not budgets, it’s entitlements 4. Flexible support, not brokerage, is critical 5. Collaboration and innovation, not purism
  • 4. The welfare state was created to tackle real problems, but sometimes created new problems…
  • 6. • The growth in the economic cost of health and social services is an international problem. • More expensive, more centralised and more institutional services grow in cost, but do not become more efficient. • Greater value lies in supporting citizenship, families and local communities, but investment in this is reducing. • How can we move resources upstream to solve problems earlier and more efficiently? An international challenge € £$
  • 8. • Personal budgets offer one powerful way of moving resources out of the wrong services and back to citizens and local communities. • Personal budgets are flexible and they let people be creative and use resources in their local community. • Personal budgets help community organisations to get funding from people - outside the procurement systems that often leads to centralisation.
  • 11. Self-directed support has been growing for 50 years
  • 12. • Personal budgets are not the solution for every problem • The need for self-directed support will reduce in fairer and more inclusive communities • Some services are better organised by collective or professional decision-making
  • 14. Value of self-direction is • not about consumer choice • not just about meeting needs • not just human rights • about meaning & love
  • 15. Agency for citizens means control and cooperation consumerism is a minimal form of agency
  • 17. 1. Finding our sense of purpose 2. Having the freedom to pursue it 3. Having enough money to be free 4. Having a home where we belong 5. Getting help from other people 6. Making life in community 7. Finding, sharing and giving love Citizenship = different and equal
  • 18. Human flourishing requires a sense of meaning and love
  • 20. • Self-direction is about meaning, the human spirit and love • The success of any system or innovation should be tested by those realities • If our work is not fulfilling for ourselves then we are not doing the right work
  • 22. People take control and so can become full citizens playing and active part in community life
  • 23. If budgets can be used flexibly then people use money differently and connect to community
  • 24. Location N Change England - 6 Sites Phase I Report 60 -18.0% England - 17 Sites Phase II Report 128 -9.0% England - 13 Sites IBSEN Report 203 -6.0% England - Northamptonshire 17 -18.7% England - City of London 10 -30.0% England - Worcestershire 73 -17.0% England - Southwark 85 -29.8% Scotland - Glasgow 12 -44.0% USA - Denver - Disabled Children - -34.0% USA - Florida - Disabled Children - -30.0%
  • 26. 4 strategies to ensure efficiency 1. Transform how existing funding is used - don’t spend new money while leaving the old system in place. 2. Make sure there is funding in place to make rights real - delegate money to local areas as much as possible. 3. Don’t restrict too much who can provide support or help people manage their budgets - keep the system open. 4. Make sure people can use money flexibly, so that they can build on what is already good in their life.
  • 27. • Transparency and clear rights convert resources into meaningful entitlements • Entitlements enable the agency of the citizen • Eroding entitlements is to weaken the effective citizenship of the person
  • 29. We’ve not paid enough attention to personalised support
  • 38. • Too often independent brokerage is treated as an inevitable requirement of any system of self-directed support • This underestimates what people and families can do • It underestimates the positive role social workers can play • and the positive role of good personalised support.
  • 40. • Relationships matter, including relationships with professionals • Social workers, support providers and others need to join the journey towards self-direction • Let’s avoid adding to the complexity of the system - where we can.
  • 43. • The system fights back - that’s why it’s taken 50 years just to get to here • Competition isn’t helping drive forward innovation • It’s time to refocus on the goal and work together