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Brokerage
The following notes are based on the Individual Budgets and
Brokerage Workshop; held at Manchester Town Hall on 10th November 2008.
MACC has raised an issue shared by many voluntary and community sector
organisations; that the rush to introduce Personalisation could deny
some people access to quality services; and therefore give them less
choice.
It will be a cruel irony if the available range of services was to be
reduced, now that the system may finally be starting to enable service
users to make genuine informed choices. Using ‘brokers’ could be a
solution to some of the concerns raised about personalisation - but not
all.
Click here to read MACC's Connections Spring 2008 (PDF).
What is Brokerage?
The following were the preferred definitions at the meeting:
- ‘brokerage is a way for individuals to get what they need, by using a
third party to act on their behalf. The role is emerging as an
essential support mechanism to empower more people on their journey to
directing their own support’;
- ‘a service broker will give advice and information and practical help to the user’;
-
‘a broker has also been described as a ‘service user’s personal
resource manager’, they should ensure that the service user is fully
involved and in control, throughout the process of choosing a care
package and its delivery’.
How does brokerage work and where does it fit in the system?
A community care assessment is still part of the process; but it will now include a self-assessment questionnaire.
To link the needs assessment to the eligibility criteria for services,
points will be allocated under each level of need. This dictates how
much money the individual will have to spend on their support.
The person will then write their own support plan. S/he may require help to do this from a: family member; friend; or ‘broker’.
Manchester wants to see the pattern of brokerage to reflect the
diversity of the City; and for brokerage to be ‘legal, decent and
honest’.
The role of the broker could include to:
-
identify funding streams;
-
support planning;
-
sign-post to services (conflict of interest?);
-
seek technical advice;
-
help identify risks and possible solutions.
In terms of ‘safeguarding’, Manchester has developed an interim policy
for Individual Budget users. This includes: the support plan has to be
legal (in terms of what you purchase); in budget; and keep you healthy,
safe and well.
Service users will not be able to spend their budgets on ‘healthcare’
or food for themselves. This raised the question again, about ‘what is
health and what is social care!’ An example given at the meeting was
that you can buy exercise in a gym but not a hip replacement.
Personal Health Budgets are to be piloted next year.
What are the funding criterion's for brokerage?
Funding for brokerage may be provided via the Resource Allocation System:
-
if it is considered an individual lacks capacity to direct their own support;
-
if the cost of support is deemed to carry considerable risk, it may be necessary to utilise a broker;
-
if the relationship with the City Council has irretrievably broken down;
-
where it could be evidenced, that paying a broker could be a more
efficient use of funds, to obtain a greater outcome (for the service
user);
-
where there may be conflict within the family setting.
How much will the City Council pay for brokerage?
As a general rule, the City Council will allocate up to £200 per
person, ‘if’ they meet the criteria for brokerage. Not everyone will
require this amount of support and the funding allocated will match
individual requirements. Adult Social Care talked about 'the Council
funding the first hour for £20' (average national quote), but this
needs further clarification. If it is likely that the individual will
require further brokerage, a request will be made to the Adult Social
Care funding panel.
Individuals who pay the full cost of their support may also wish to use a brokerage service.
Who are the brokers?
Manchester has decided that all external brokers need to be accredited
with the City Council. It will be up to the provider, applying for
accreditation, to demonstrate that the organisation will have checks
and balances in place, to show that there will be no conflict of
interest.
The City Council ‘brokers’ will eventually work from the developing
‘Business Units’ in each ward. The Council are working towards having
an accredited list of organisations, which could provide: a brokerage
service in each locality; a service for particular communities of
interest - though the latter needs further clarification by the City
Council.
Issues were raised about the ‘independence’ of the brokerage services.
Recently at the Manchester Older Peoples Network, older people
themselves wanted reassurance that brokerage services would not be part
of a service provider marketing process. The voluntary and community
sector acknowledged that this would also be an issue for themselves as
providers of services. However, their real concerns were ‘how a
brokerage service could sit alongside an advocacy service’. This was
stressed as an important point requiring further discussion.
Time-scales for having an effective, diverse brokerage service in place are unknown at this point.
How does a voluntary sector organisation develop a brokerage service?
Organisations need:
- to be accredited;
-
to market themselves;
-
to identify their training needs.
The City Council’s, Adult Social Care Department, is currently taken on
four secondments from four organisations; to provide training on how
the service is likely to function.
The initial opportunity for the voluntary and community sector to apply
for accreditation has now passed. We are awaiting clarification on what
opportunities will be available for other organisations in due course.
For further information please contact Julie McConnell at Manchester City Council:
Email: julie.mcconnell@manchester.gov.uk
Telephone: 0161 277 1823.
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