Evidence Submission: Individual Budgets

Individual Budgets (IBs) aimed to give  social care users more choice and control over their own support arrangements, by giving them cash payments to spend  so they can tailor their care to their personal needs and not just to what is offered.

Individual Budgets were piloted by the previous Labour Government as a cross-government policy in 13 local authority pilot projects. The pilot included the main social care adult groups: older people, people with physical and/or sensory disabilities, people with learning disabilities and people with mental health problems.

The Department of Health funded an evaluation of the Individual Budget pilots, which was conducted by a consortium of three research units in five universities. The evaluation had a mixed methods design including a randomised controlled trial and in-depth interviews with service users, carers, user and carer organisations and lead officers responsible for IB implementation.

This report, by the Making the Most of Evaluation research groups, appraised the findings of the IB pilot evaluation. It concluded that the evaluation was the most extensive and rigorous evaluation of self-directed support to date. The evaluation showed that IBs had some, if limited benefits and only for some groups such as those using mental health service and to a less extent for those people with physical and/or sensory impairment. IBs were more cost effective that standard care for these two groups but there was little evidence of any benefits for older people. Moreover, there were major barriers to integrating funding streams, which was one of the key aims of IBs.

Despite this uncertainty about effectiveness, individual budgets continued to remain high on the government policy agenda, and the concept was exported from social care to health care as the Department of Health launched a pilot programme in 2009 to explore the potential of personal health budgets.

The coalition government’s long-term plans for the NHS, as outlined in the NHS White Paper “Equity and excellence: liberating the NHS” had a strong emphasis on choice and competition, and has proposed to use the evaluation results of the personal health budgets pilot programme in 2012 to inform a wider roll-out of personal health budgets.

Click here to read the report in full and you can read the summary report of all the reviews here.