We have sought to show how personalisation has been arrived at as a solution to past problems, but it should be evident that many uncertainties and issues still have to be resolved. Even if some elements of personalisation have been with us for some time, it is still a relatively young approach and it is still very much a work-in-progress. The passing of the Social Care (Self-directed Support) (Scotland) Act 2013, based on principles of involvement, informed choice and collaboration, is a very important step in the direction of personalised services.
However, ‘the proof will be in the pudding’: the Act’s success can only be measured in terms of the positive difference it makes to outcomes for service users and carers. Even if the main principles of personalisation that we have set out are widely accepted in Scotland, a number of key questions for the future remain, for example:
- How easily will the culture of care and support shift in Scotland - to move towards a co-productive approach and ‘outcomes-based’ thinking, with the 'citizen' - not services - at the centre?
- What is the right balance between keeping people 'safe' and enabling people of all ages to experience new opportunities and make potentially life enhancing choices about their lives?
- Will lack of regulation of personal assistants put people (including personal assistants) at risk of harm? Or will it increase flexibility, reduce ‘red tape’ and make it easier for service users to direct their support?
- What will be the impact of self-directed support on the workforce and the roles of, for example, social workers and social care workers? What changes are required to support a transformation in the way that care and support are provided?
- What will be the impact of cuts in public expenditure – if these are sustained – on self-directed support? Will self-directed support then be perceived as – or become – a form of cost-cutting by the ‘back door’?
- How easy will it really be to build a sufficient level of ‘social capital’ to provide a sustainable community infrastructure that can work in a reciprocal and effective way with the public sector?
- Will people who are subject to compulsory measures (e.g. detained under mental health legislation, on compulsory supervision orders) benefit from the shift to greater personalisation and self-directed support?
- Will the policy of Getting it Right for Every Child ensure that the child or young person is always 'at the centre' of their care and support? How will planned legislation to promote integration of health and social care support the progress of ‘joined up’ personalisation in Scotland?
So we end with questions rather than answers! We’ve shown that personalisation in Scotland has long historical roots, with an extended gestation period in the 1990s and 2000s – but the signs are that it is here to stay. Nevertheless, the questions we have outlined will need to be answered effectively if personalisation and self-directed support are to develop further and become fully established and accepted as central to health, social care and other services in Scotland.
We hope you have enjoyed this course on personalisation and self-directed support in Scotland, whether you have just dipped into one or two of the sections, or you have engaged with all the material. This course was not intended to be the ‘last word’ or to be totally comprehensive. Instead we have aimed to provide you with a grounding in the culture and type of thinking that is needed to implement personalisation and self-directed support for people in Scotland, and introduce you to the many debates surrounding these changes.
Statement of participation
You should aim to complete all the quizzes at the end of each section.
To show that you have participated in the course you can obtain a Statement of participation. You should receive an email notifying you about this within 24 hours of completing the course.