Guest blog By David Wolverson: The Winterbourne case review – why a fundamental rethink of policy is needed.
“…and then comes the next abusive incident, because fundamentally nothing has changed the systems.”
As I started to read the reviews and responses, my first thought was ‘Here we go again.’ In the last 5 years alone remember Budock Hospital and then Orchard Hill? The hand wringing, a modicum of acknowledgement of failure from all sides but of course with some reserve for self preservation, ‘ it wasn’t just us who failed, look at the other players too….’ As ever to assuage the public indignation, we will get some ‘fix-its’, a bit of retribution in terms of those convicted, a bit more regulatory process and commissioning bureaucracy and a sincere hope it all settles down again! After all, Government, the courts, and the agencies have all been seen to have done something. And then comes the next abusive incident, because fundamentally nothing has changed the systems.
What have we really learnt from this and other cases?
“There appears to be nobody within the government, NHS or Local Authorities willing to rework the system.”
The system is broken and dysfunctional. There appears to be nobody within the government, NHS or Local Authorities willing to rework the system. To repeat the often used phrase ‘if you keep doing what you have always done you will continue to get what you have always got!’ A few providers are changing the way they work but they constantly struggle with staying true to their intent to become person- centred whilst rubbing up against a system which acts against this direction and is by and large driven by cost.
What is the root of the problem?
“It is ironic that we are probably victims of having clear policy directives!”
It is ironic that we are probably victims of having clear policy directives! What is to argue with about personalisation, outcome based commissioning, choice and control and personal budgets? The policy job is done on paper – just like Castlebeck had excellent policies and procedures for Winterbourne. It seems so many professionals are able to express their actions utilising all the ‘buzzwords’ and are affronted when it is pointed out that their actions may be demonstrably focussed on the person but they are not person centred because they have not emanated from the person. But it gets worse than that,! There are plenty of examples of professionals and organisations using the words but very knowingly and underhandedly manipulating situations, because of the vested interests of LAs, NHS trusts and providers – ‘users’ (“heads in beds)’ mean income why would we let people make choices that affect our income and service provision!
How do we fix this, fundamentally, for good?
“How do all the agencies genuinely start to listen to people who use their services?”
How do all the agencies genuinely start to listen to people who use their services? This is not in a subservient way but in an adult conversation about what is possible both in terms of service type and resources. Professionals both medical and social care need to stop making decisions and start sharing their wisdom and experience to assist people in identifying what is possible and what choices they may have.
We need to design our health and social care systems back from the ‘user’, fundamentally. In this way the focus on the primary relationship between the person receiving support and the worker is nurtured and becomes central to the system. Easy to say but a major transformation, which so far seems to be eluding all the players from the Government downwards.
“We need to design our health and social care systems back from the ‘user’, fundamentally.”
Can providers work in a person-centred way, regardless of the contract or the existence of a personal budget? I believe they can, having experienced that sort change process in a provider. There are no quick fixes, but the engagement of people who are supported , staff , Boards and other stakeholders working on the issues is a powerful mix. The question is, ‘Are you ready to unleash that power and move your organisation to a very different place?”
David Wolverson was Chief Executive of Dimensions until April 2011. He has worked in the Social Care and Housing sector since 1973 and has since carried out consultancy and interim roles.
David is working with Excitant to help third sector organisations tackle austerity whilst remaining authentic to their values. We call it “The New Tracks” service.
Are you facing the pressure of Austerity, whilst wishing to remain authentic?
For Chief Executives in the voluntary sector who recognise that the pressures on the sector mean that their organisations must change, “New Tracks” helps you to find better ways to manage and deliver services by conducting a fundamental management review and helping you set an agenda that navigates your way through .
Unlike traditional cost cutting and efficiency solutions, New Tracks positions you for a future of continued austerity, personalisation and new opportunities.
To explore whether “New Tracks” could help you, contact us