English Policy and Practice Roundtable

This week, IMPACT and the Centre for Care hosted an English policy and practice roundtable.  

David Brindle chaired, introducing the session as a chance to look at the opportunities in the policy and political cycle to exert influence. We also wanted to look at how and where people with lived experience have been able to influence. The session was designed to be interactive, with a series of quick “lightning presentations”, chances to ask questions and have group discussions.  

The event was a launch pad for action and change, with ambitions for an action mobilisation network to amplify voices and bring people and organisations together. 

The first presentation was by Luke Nash, a member of the Co-production Advisory Group and campaigner. Luke told us what choice and control, and independence, mean to him, and why it’s important to have the right PA. 

People who are not disabled but are in charge of processes and policies often have a definition of independence in their psychology. Independence has a different meaning for me, as to many disabled people. 

It is not always about living on your own. How am I, as a disabled human being, meant to live an independent life if I can’t be understood or have a normal conversation with people. I need the right personnel to integrate me into society as I want to live my life. 

Catherine Needham, Professor of Public Policy and Public Management at the University of Birmingham, presented on the conflict between individualisation (choice and control, direct payments) and standardisation (centralised services, consistency). She concluded that we need to move away from a “best of both” approach, and that choice is most important – maybe it will destabilise markets but, as is IMPACT’s mission statement, “Good support isn’t just about ‘services’ – it’s about having a life.” 

We were joined by Nathan Jones, Senior Policy and External Affairs Lead at the National Care Forum, who presented on co-producing change. Nathan set the scene, explaining that much of what we have seen from politicians and policymakers on choice and control only pays lip-service to the idea of co-production. But as we enter an election year, we have an opportunity to change this. 

Nathan co-chairs the All Party Parliamentary Group on adult social care, which is now coordinated by a working group and a Lived Experience Advisory Group. The group felt it was important to support the My Vote, My Voice campaign which seeks to ensure elections and democracy is more accessible and easier to participate in. 

Catherine emphasised that even when politicians are being more ambitious, like with plans for a National Care Service in Scotland, they are very focussed on integration. 

David asked what is more important to Luke: feeling safe, and minimum guarantees, or having flexibility and choice? Luke says it’s a combination of both. 

Nathan described it as a stark choice. When dealing with Ministers and government departments, they want something simple but it’s important that we make this more complex. The Labour model of locally accountable, funded nationally, best of both thinking – but can that work?? 

Anne Pridmore, CEO of Being the Boss (an organisation she started 15 yrs ago when people started getting Direct Payments and had no support/experience with being a manager) remembers campaigning in the 1990s because they thought Direct Payments would solve a lot of problems. In the beginning, things were good, but many Local Authorities “jumped on the band wagon” and there was no real benefit for people in receipt. She also said that the high turnover in the role of Minister for Disabled People is saddening. 

Jon Glasby, Director of IMPACT said that we prioritise equality in public services, but when we all start from different points those equalities continue. We should move to equality of outcome rather than equality of input, so everyone reaches the same point regardless of where they start  

David asked Catherine Needham: do we regulate the task force or leave people free to recruit whoever they wish, regardless of qualifications? Catherine said it feels it should be a choice people are free to make. Other nations in UK do have registration schemes but have they really addressed issues of scarcity, pay, lack of progression?  

Luke said he struggles with PA recruitment – had adverts out for months but everyone that comes through agencies is the same type of person and they’re not who he needs. Luke wants to work and live but they provide a basic service of washing, feeding, and cleaning. 

Nathan added that registration/regulation can only work if they’re alongside improvements to pay, conditions, training – raising the status and meaningful care would have a transformative effect. The recent publication of care workforce pathway isn’t pinned to pay scales and didn’t involve the voices of people.  

Sue Yeandle, Professor of Sociology in the School of Sociology and Social Policy, and Co-Director of CIRCLE (Centre for International Research on Care, Labour and Equalities), said that especially when care is delivered at home, people should 100% be able to pick but other factors like pay, training and a lack of resources are real challenges. She added that additional support should come at the cost of the state rather than the individual.  

Martin Nicholas, from Partners in Support, added people should be at the heart of choices, and that while training is important, it won’t make a huge difference.

Ewan King, CEO of Shared Lives and IMPACT’s Deputy Director/Head of National Embedding, presented on the Shared Lives model, how it has grown and developed and what IMPACT can learn from their journey, including around accessible communication, and using varied evidence.  

Kate Hamblin, IMPACT’s Networks lead, presented on the values-based recruitment Network. She shared that while participants didn’t necessarily recognise it as an approach, it was a natural way of working for people recruiting PAs. She explored the challenges and feedback from participants. 

Richard Brunner, our Demonstrator on the PA wellbeing project, presented on their progress. He shared the context in which they’re working, under self-directed support in Scotland, and what approach the project is taking.   

On tables, attendees discussed either workforce, digital or personalised care. Feedback covered approaches to recruiting more men, how we can use tech and AI, how individuals recruiting Pas can take a more personal approach and care collectives.  

Laura Griffith, Rachel Black and Becky Driscoll closed the event with their key takeaways, from how we can build networks and communities going forward, and how we can start from the outcomes that matter to people.  

Please get in touch with [email protected] should you want to express your interest in being part of an action-based network.