Over the past few months I’ve been working with Alzheimer’s Society’s ‘Personal Choice Programme’, helping them to communicate their work more effectively.

One of the workstreams we have been working on looks at Direct Payments, a system through which eligible individuals (or their carers) can claim money from their local authority to pay for their care and support needs. This is instead of the council simply organising care and support on their behalf, and moves the choice and control from the local authority to the person in question. Doing this can give people a much wider range of support providers and activities to choose from, and, as a result, transform their daily lives.

So far so good, but it took me a while to really get my head around Direct Payments and what they can do. Here’s why – the communications around them need a rethink.

Through my work, I’ve come up with a few ideas around how Direct Payments could be communicated better to the general public. Here are five of them:


1. Focus on the benefits, not the process

Most explanations of Direct Payments start with the nuts and bolts of how they work, without being clear about why you might benefit from them.

Here’s one example (from Direct.gov):

‘If you or someone you care for get help from social services, you can apply for direct payments. These let you choose and buy the services you need yourself, instead of getting them from your council.’

For someone who knows how councils work, and understands the restrictive nature of preferred supplier lists, this might sound appealing. But for someone new to social care and support, the first thing they would think would be ‘why bother?’.

Once you get into the detail, things get even more scary (source):

‘Once the funding is agreed we can help you to manage your money and can provide a range of supportive information on all aspects of the scheme including employing your own Personal Assistants. We can support you throughout the recruitment process from writing the job description through to setting out contracts. We also provide support with paperwork and financial returns.’

Sounds like a lot of work – especially if the council could just manage the whole thing for you. Again… ‘why bother’?

What councils need to be upfront about is that the choice of services, activities and providers may be severely limited if you choose council managed care and support. By taking a cash payment, and paying for services that suit you, you may be able to design a better care and support package that helps you to live your life the way you want. This is the key benefit of taking Direct Payments, and needs to be prioritised in messaging to engage with the public more effectively.


2. Build a central online information hub

If someone is looking for information on how care and support services work, the internet can be an overwhelming place to start.

There’s no central hub to explain how to access social care and support. And even before getting to that stage, people might not understand the difference between health and social care. After all, why would they if they’ve never accessed social care before?

Assuming that a person finds their way to a council website, and decides to visit the social care page, you might think that pages on ‘ways of paying for care’ and ‘Direct Payments’ would be easily found. However, this is often not the case either.

For example, Manchester Council has now removed information on Direct Payments from their site altogether.

Other councils have information, but you can’t navigate to it, and can only find it if you already know to search for ‘Direct Payments’ in the search bar.

A new, national online presence explaining access to social care and support is needed. Although councils do offer differing services to some degree, the general principles and options of how a person pays for their care and largely the same across the country. It’s time we make it easier for people to find and to understand.


3. Use language consistently

Direct Payments. Personal Budgets. Personal Health Budgets. Managed Budgets. Mixed Budgets. Individual Service Funds. Personalisation.

It took me a while to get my head around these terms. They all seem similar, and in fact, many organisations seem to be using some of them interchangeably, as in this example (source):

“Personal Budgets and Direct Payments are types of funding which may be paid directly by local authorities to enable people to independently purchase the social care services and support which they have been assessed as needing.”

This lack of clarity over the terms serves only to confuse people who are looking for help. Again, a central information portal around paying for care could help to clarify how these initiatives work.


4. Keep things simple

The site mentioned above then goes on to say:

“Personalisation is about people being in control over the support and services they receive and ensuring they are at the centre of any decisions made.”

I struggle to see the value in explaining the social care term ‘personalisation’ for people who are looking for care and support. Even within the field, the term has a wide range of interpretations. For the general public, a ‘plain English’ explanation would be more appropriate.

Add in the other terminology too and you end up with an overly-complicated information resource that would put off even the most determined of us!


5. Make it relevant

To help people to grasp what Direct Payments could do for them, we need a wider range of case studies.

Currently the majority of Direct Payments case studies focus on individuals with a physical impairment and full mental capacity. People living with dementia, for example, appear infrequently; and as such it can be difficult to see what the benefit of taking on a Direct Payment could be.

These case studies could also help social care professionals who may not have experience in implementing Direct Payments to see the wide range of activities and services they could pay for.


If you’d like to know more about the work I’ve done with Alzheimer’s Society, please get in touch.