Tag Archives: social care

A pathway to precarity? Young workers and zero hour futures in the social care sector

Montgomery-Mazzei-Baglioni-SinclairTom Montgomery, Micaela Mazzei, Simone Baglioni, Stephen Sinclair

In an effort to solve crucial issues such as youth unemployment, policymakers can find it tempting when it looks like there is an opportunity to kill two birds with one stone. When you have a population living longer and requiring personal care for many years to come it can seem logical that there is a future in that sector for a generation of young workers. However there is a risk that the prospect of new potential employment for young people eclipses an awareness of the quality of work available in that sector.

Our recent article in Policy & Politics entitled Who Cares? The social care sector and the future of youth unemployment explores the actual potential of the social care sector in the UK to offer good quality career pathways for young people. Continue reading A pathway to precarity? Young workers and zero hour futures in the social care sector

Who knows best? Understanding older people’s experience of emergency hospital admission

glasby-littlechildJon Glasby and Rosemary Littlechild

An extended version of this post was originally published on 4 October 2016 in the Policy Briefing section of Discover Society which is provided in collaboration with the journal Policy & Politics. The original post is available at http://discoversociety.org/2016/10/04/policy-briefing-who-knows-best-understanding-older-peoples-experience-of-emergency-hospital-admission/.

Every year, the NHS experiences more than 2 million unplanned hospital admissions for people over 65 (accounting for 68 per cent of hospital emergency bed days and the use of more than 51,000 acute beds at any one time).  With an ageing population and a challenging financial context, such pressures show no sign of abating – and the NHS is having to find ways of reducing emergency hospital admissions (in situations where care can be provided as effectively elsewhere).  Often, the assumption in policy and media debates seems to be that potentially large numbers of older people are admitted to hospital without really needing the services provided there, but because there is nowhere else for them to go or because other services are not operating effectively.    Continue reading Who knows best? Understanding older people’s experience of emergency hospital admission

Policy & Politics: Making it personal

Personalisation is squarely at the heart of current policy debate around adult social care. For the last 10 years the British government has been experimenting with moving away from assisting users through providing services drawn from a relatively short menu of possibilities. Personalisation gives users personal or individual budgets and allowing them discretion to determine how they think the money should be best spent to meet their own understanding of their needs.

From a policymaking perspective it is a fascinating development because stakeholders from very different perspectives feel able to support it. The market liberals see it as a means of introducing competition and choice into public service provision, while those more concerned with autonomy and dignity see it as a means of empowering service users. Those concerned about the size of the welfare budget see it as a more efficient way of achieving positive outcomes for those receiving assistance. With such diverse constituencies lined up behind it, it is perhaps not surprising that the personalisation agenda has momentum.

And this is the case despite the need for several notes of caution. First, there is the tension between the individualisation of welfare and society’s collective responsibility for meeting the needs of its population. Second, there are concerns that personalisation may be great for some but it is not necessarily beneficial for all recipients of social care – older people in particular. Third, the evidence that personalisation delivers cost savings and enhanced outcomes is promising, but by no means overwhelming. Some would contest it vigorously.

Debate about personalisation can also occur at a more conceptual level. Precisely what type of state intervention does it represent? It is not the sort of direct service provision that much of social care provision has traditionally been based upon, but at the same time it isn’t a pure income transfer of the type so beloved by economists. In a paper in the current issue of Policy & Politics Simon Duffy and his colleagues offer a framework for thinking about personal budgets as a conditional resource entitlements (CRE). The characteristics of such entitlements can be examined in relation to five dimensions: autonomy, flexibility, targeting, support and conditionality. The authors argue that the nature of the conditionality associated with personal budgets differentiates it from other types of CRE: the focus is less on how resources are spent and more upon outcomes.

Perhaps the most interesting aspect of this issue is what personal budgets might tell us about future directions for welfare. Here Duffy et al offer a brief discussion of three possible scenarios. First, personal budgets are a transition in the move towards pure income transfers. Second, personal budgets represent an optimal state – they represent the best of both worlds. Third, personal budgets represent a stage in the process of shifting greater responsibility for meeting need away from the state and towards the individual. These are all plausible futures. Which one is realised will depend in part on how we make sense of the agenda and how we narrate it. Whether we embrace it uncritically or whether we contest it. There is much still to play for.

Duffy, S., Waters, J. and Glasby, J. (2010) ‘Personalisation and adult social care: future options for the reform of public services’, Policy & Politics, Volume 38, Number 4, October 2010*

Alex Marsh, Management Board, Policy & Politics

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Also available: Direct payments and personal budgets: Putting personalisation into practice by Jon Glasby and Rosemary Littlechild