What does ‘good’ look like?

Leaders and decision-makers within the health and social care sector generally grasp (and subscribe to) the concept of Personalisation and Self-Directed Support; but often feel ‘stuck’ in relation to the systems, structures and processes that they are required to work within.

Having a simple lens by which to review policy and practice could be a catalyst for real and lasting change.

Let’s explore this in a little more detail.

Independent Support Brokerage is an approach which strongly aligns with the theory of self-determination and was first developed by families of people with complex needs, called the Woodlands Parents’ Group in British Columbia, Canada in the 1970s.

When the person is in the driving seat of their own life, amazing things can happen; and solutions and opportunities can be discovered which were not even considered through the narrow lens of commissioned provider services and statutory provision from Health and Social Care. Elements of Support Brokerage exist in many different models and approaches, but authentic and truly Independent Support Brokerage is rooted in a wide range of Person-Centred Practice and Strengths-Based Approaches such as:

• Asset-Based Community Development (ABCD)
• Local Area Coordination
• Social Prescribing (Social Prescribing Link Workers)
• Community Circles
• Person-Centred Planning
• Appreciative Inquiry
• Personalised funding (such as Personal Budgets and Personal Health Budgets)

Some of the barriers and challenges presented by the current Health and Social Care system include:

• Inflexibility in the use of Local Authority and Health resources
• Discomfort and risk aversion from statutory bodies in shifting power to individuals and communities
• Mistrust of individuals as commissioners of their own support
• Lengthy delays in responding to need due to an inefficient and overstretched system structure
• Lack of information sharing by statutory bodies to the individual 
• Siloed services designated by label and determined by the commissioning process/provider market rather than the individuals who require support
• Stifling the creative and flexible use of resources due to hierarchical (and time-consuming) decision-making
• Ineffective assessment of the financial circumstances of an individual which impacts on the level of resource they can receive towards their support
• Lack of recognition by a statutory body that achievement of outcomes means that a person’s needs are being met; and therefore funding should remain in place to meet need and should not be withdrawn or reduced

Our experience as practitioners of Independent Support Brokerage has shown that many of these barriers and challenges can be overcome when the following conditions are present:

• The conversation starts with the person and ensuring they are fully in the driving seat of the process
• Developing a strong sense of who the person is, and what they want to achieve
• Understanding and recognising the strengths and connections around the person
• Start by looking at what is available within the person’s local community before looking at agency solutions
• Helping the person to understand the range of options for managing their budget and planning their support
• Ensuring that there is clear information available in an accessible format to ensure that people are fully informed about their rights and choices
• Ensuring that the person has their voice heard
• Recognising that the assessment and the Support Plan are only a small part of the person’s life as a whole
• Simple and efficient processes for assessment, planning and arranging support
• Flexibility and freedom to create solutions which make most sense for the person and allow the most efficient use of resources
• Information-sharing processes between professionals which prevent the person from having to share their personal details and circumstances repeatedly

The mechanisms and legal structures enabling these conditions to be present already exist, and it is happening in small pockets around the UK. 

So why isn’t it happening everywhere? There is a growing groundswell of momentum towards the radical transformation of the welfare state. The Health and Social Care sector forms one part of the puzzle. There are many refrains of ‘Coproduction’, ‘Personalisation’, ‘Strengths-Based Approaches’ and ‘community development’ being sung by different groups wanting to see change.  If we gather our voices together collectively and sing as a choir; we could weave our harmonies together to create a symphony of citizenship, inclusion and equal rights for all. 

Do you want to join the chorus?

We are in the process of developing a set of quality standards which map across to other aligned quality standards and outcomes indicators for the health and social care sector. Visit our website: https://www.imagineer.org.uk// to sign up for updates; and read our latest paper: ‘What does ‘good’ look like? to find out more.

About us: 

Liz Leach Murphy is the Founder of Imagineer Development UK CIC, Chair of the National Brokerage Network and a Freelance Consultant working on personalisation within the Health and Social Care sector/community space.

Sarah Holmes is a Freelance Consultant working on personalisation within the Health and Social Care sector/community space; and a Director of Imagineer Development UK CIC

Both Liz and Sarah are practitioners, trainers and coaches in Independent Support Brokerage and consultancy for Strengths-Based Approaches with collectively over 40 years of experience in the Health and Social care and community sectors.

Imagineer Development UK CIC is a social enterprise based in the North of England with a national reach; originally set up as a testbed for Independent Support Brokerage in the UK. Imagineer is the hosting organisation for the National Brokerage Network, which is a community of practice for Independent Support Brokers. Imagineer provides a range of training in Support Brokerage, Person-Centred and Strengths-Based Approaches.

Further reading: What does ‘good look like?: https://www.imagineer.org.uk//wp-content/uploads/2020/08/What-does-good-look-like.pdf

Sign up to our mailing list to be kept updated on our work in developing quality standards for Person-Centred practice and Self-Direction: https://www.imagineer.org.uk//

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