IB Pilots experience in Mental Health settings

1
IB Pilots experience in Mental Health settings

• Carey Bamber, Personalisation Programme Manager,
  CSIP NW

2
Background to IB Pilots

• NHS and Community Care Act (Direct Payments) 1996
• In Control 2003
• Individual Budgets Pilots, DH 2005
• 13 Sites selected
• Key elements of IB process
• Funding streams not including health money

3
Anecdotal Pilot site experiences

• 4 sites
• Barnsley, Lincolnshire, Norfolk and Oldham
• Adults and OP with mental health support needs
• Single RAS - fluctuations, risk
• Early IBSEN Paper cites complexity and challenge
  for implementation in mental health and OP
  settings
• IB Pilot funding streams limitation
• 80 on 20

4
Cultural Challenges

• person centred approaches - knowing whats
  important for people, but not whats important to
  them
• anxiety about risk and what people would do with
  the money
• low expectations - staff and people themselves
• These people are all too poorly
• lack of any experience of self direction (e.g.
  Direct Payments)
• Not my role / job /how I work / what I do / what
  I was trained for
• Creativity, and strengths based, not deficit
  model
• OUTCOMES
• Some great exceptions in all Teams

5
System Challenges

• Brokerage and Advocacy need to be extensively
  available and robust
• Ensuring a fit between system based process of
  care planning (CPA) and PC approaches
• FACS (whats that?)
• Disaggregating the money
• Medically dominated model
• Loss of social care
• Models of risk management
• Focus on provided services, not support - and
  working with providers NOW
• Equitable share of the resources - getting the
  money right.

6
What did people do when they got control of the
money?

• It takes time to develop a good plan
• As per Direct Payments - lots of goods
• -Bikes, gym membership, camera, tent, shelves,
  computer table
• Support - to go to a class, get a job, house
  keeping, paperwork, get out and about, to stay at
  home and not go into care.
• Services -dating agency, driving lessons, ironing
  / laundry, gardening.
• Flexibility was key.
• Some stories coming up shortly.

7
What did staff say afterwards

• Its like motivational interviewing and CBT
  rolled into one!
• It changes peoples mindsets- it focuses on the
  positive and it gives them hope
• It makes them feel an individual and not a
  patient - more normal and socially acceptable
• IBs empower clients who feel disempowered by
  services
• IBs can build rapport between clients and care
  co-ordinators
• Norfolk Care Coordinators, 2007.

8
Karens story