factors aiding and hindering implementation of direct payments

1. Factors Aiding and Hindering Implementation of Direct Payments Paul Swift Foundation for People with Learning Disabilities Michael Hill Health and Social Care Advisory Service

3. Carrying out the study Phase 1 – literature review & policy-maker interviews Phase 2 – questionnaire survey of local authorities and direct payment support organisations, and follow-up telephone interviews with 50 of each Phase 3 – case studies of implementation of direct payments in 7 local authority areas These are very preliminary findings based only on the mailed questionnaire to local authorities and to support organisations

4. Factors aiding and hindering implementation Data based on opinion responses List of 18 potentially aiding and 17 potentially hindering factors generated from a review of central government drivers and research literature Local authority and support organisation respondents asked to tick where factors applied They were asked to rate whether the factors were ‘helpful’ (‘unhelpful’), ‘important’ or ‘critical’ Main focus of analysis on frequency with which factors identified rather than on weighting assigned

5. Categorisation of factors Influences from central government Factors influencing the overall disposition of local authorities Factors influencing local authority operational arrangements Supporting influences stemming from the voluntary sector Demand from service users and carers Wider features of the policy environment

6. Main aiding factors (England)

7. Two items rarely mentioned Ring fenced budgets for direct payments (25%) Support of public sector trade unions (12%)

8. Variations between authority types Variations generally quite slight Partial exceptions lower rates of identification of importance of local leadership and demand in new unitaries Staff attitudes deemed less important in metropolitan authorities Any regional variations likely to be associated with variations in presence of types of authorities

9. Main hindering factors (England)

10. Do the factors explain local authority performance differences? Comparing ‘performance’ – a note of caution! Measure of performance derived from 2004 direct payments figures for adult care groups per 100,000 population Early findings for English local authority sample: In general, higher performing authorities were more likely to identify aiding factors Results for hindering factors were less clear Work in progress using a range of statistical techniques suggests the particular importance of local authority commitment Main Correlations reported here

11. Aiding factors related to levels of expenditure There was a general tendency for higher spending authorities to be more likely to identify aiding factors (exceptions: flexibility of commissioning and impact of monitoring and inspection Significant correlations found for: Leadership within the LA Local political support Training Direct payt. Development fund awards Positive attitudes amongst staff Ring-fenced budgets

12. Hindering factors related to levels of expenditure Much less clear results Only one significant correlation: lower paying authorities reported lower levels of demand

13. Reinforcing data from support organisations While since LA responses may have been influenced by knowledge of their own performance, this will not necessarily apply with support organisations. Hence interesting to note how support organisations were more likely to identify aiding factors in areas of higher expenditure, with positive correlations in respect of: Local authority leadership Training Demand

14. Conclusions Many more aiding than hindering factors identified by English local authorities Central government drivers (modernisation mechanisms) have had some impact However, greater importance of the overall disposition of local authorities and their operational arrangements suggested Evidence of a tendency for the higher performing authorities to identify more aiding factors but more mixed results on hindering factors