Managed budgets

The IMPACT Network on choice and control in 2022 explored personalisation for adults with mental health conditions and/ or learning disabilities. Traditional funding models tend to involve public authorities directly funding service providers (through public procurement or reserved markets). This can dominate and limit the choice and controls of individuals with support and care needs. In contrast to this, user-centred funding models (such as Personal Budgets) allow room for flexibility when designing and providing services so they can be more tailored towards the needs of individuals. In Northern Ireland there are 4 options for Personal budgets:

1. Direct payment – money is given to the beneficiary instead of services that would have been provided, or purchased by the Health and Social Care Trust

2. A managed budget – allows the beneficiary to have flexibility and choice without becoming an employer and managing the paperwork

3. Trust arranges support – the Health and Social Care Trust arranges the support

4. The person with support needs can choose option 1, 2 or 3, or they can choose a mix of 1, 2 or 3 to best suit them

In Northern Ireland, some elements of Personal budgets (also called Self-Directed support) are used, but ‘Managed budgets’ are not yet being implemented to their full potential. IMPACT ran a workshop in October 2023, together with ARC to explore the challenges, blocks and frustrations in the system. An IMPACT ‘showcase’ event shared examples from across the UK where some of these have been navigated.  Presentations from Self-Directed Futures and In-Control Scotland gave examples of what was possible. Health and Social Care Trusts developed a theory of change and did some action planning around what needed to be done. This project is continuing with that work by providing a focus and support with evidence-based systems change and implementation. The Senior Strategic Improvement Coach, Helga Sneddon, from IMPACT is being hosted by SPPG and will look at what changes are still needed and how budgets can be implemented to make them a reality. Between September 2024-August 2025, this will focus on implementing ‘Managed Budgets’ for adults with learning disabilities across Northern Ireland.