This document discusses Individual Service Funds (ISFs), which are personal budgets held by an organization on behalf of a person in need of support services. ISFs give more choice and flexibility than traditional commissioned support. The document provides examples of how ISFs have been implemented in various areas to transform systems and support deinstitutionalization. It also outlines the benefits of ISFs compared to direct payments or commissioned support, as well as the types of organizations that can hold ISFs.

1. How Individual Service Funds are
transforming commissioning

2. • Started a support worker in NHS locally based hospital units for people with
learning disabilities, worked in residential care then in community based/supported
living services and as a personal assistant
• Moved into a joint LA/NHS role and took on part of NHS ATU closure programme
in Dorset (the team moved 154 people into own homes in local communities)
• Worked in LA/NHS commissioning for several years leading on Transforming Care
programme and the Autism and Learning Disability partnership boards – set up
ISF offer in 2015
• Set up own company which now works with local authorities and CCG’s to
redesign systems to improve access to personal budgets
• Also run a ‘Community Micro Enterprise’ supporting people with learning
disabilities, autism and people with mental health issues (ThreeSixty Inclusive)
• Freelance as an associate consultant with other organisations including the Centre
for Welfare Reform, PeopleToo and the Institute of Public Care at Oxford Brookes
University
Linkedin CV: https://www.linkedin.com/in/christopher-watson-frsa-10268a22/
About me

3. CfWR consultancy
The Centre provides practical assistance,
training and consultancy to a whole range of
organisations including: support providers,
voluntary and community sector organisations;
clinical commissioning groups; local authorities
and others who aspire to make radical change
for the benefit of citizens.
The collective knowledge, skills and experience
of the Centre means that we are able to provide
practical advice and support on a whole range
of issues.

4. • Co-production & visioning
• Commissioning support
(developing strategy, business
cases, pilots, programme plans)
• Training for social workers and
providers
• Market engagement
• Stakeholder consultation
• Organisational coaching &
mentoring
• Tactical support
• Outcomes and financial impact
evaluations
Our ISF support offer

5. Individual Service Funds are about citizenship
© Simon Duffy
• Moving away from the ‘professional gift’
• Away from people being seen as grateful
recipient of services
• Towards having clear entitlements
• Freedom to use creativity and own judgment
• Away from segregation towards citizenship
and community
• Building good lives not just receiving
services

6. Progress in the commissioning of care in past
20 years
or

7. Setting up ‘support’ for 12 months+

8. Fixing support weekly into rigid
contracts
• No mechanism for returning unused
funds
• Non-compliance if you don’t deliver the
hours commissioned
• People are left for 12+ months without
reviews
• Direct payments often money left in
holding accounts at end of a year but
never money back from commissioned
providers
• Evidence continues to emerge that ISFs
used creatively lead to savings

9. What are Individual Service Funds (NHS Third
Party Budgets)?
© Simon Duffy
• A personal budget held by a
nominated organisation on behalf of
the person
• It’s the persons entitlement after
assessment
• Can either be via a Direct Payment or
a commissioned arrangement

10. Simple ISF arrangement
• Assessment and support plan
details who the person would like to
hold their ISF
• Agreement between the funder and
the ISF holding organisation
• Agreement between the person and
their ISF holding organisation
setting out how they will work
together to use their budget
© Self-Directed Futures

11. Difference between an ISF and
commissioned support?
ISF Commissioned
Paid like a direct payment – usually in
advance
Paid in arrears via invoice
Working in stronger partnership with
social services to deliver support
Deliver support as specified by social
services
Co produce support plan with the
person and keep it ‘live’
Given a social services support plan to
follow
Can lead commission and organise
other services that the person needs -
more flexible
Social services commission all
elements of support package – less
flexible

12. Continuum of options

13. Underpinning Legislation

14. Underpinning Legislation
• Health and Social Care Act 2012 requires Clinical
Commissioning Groups to promote the involvement of
each patient
• Care Act 2014 requires local authorities to involve adults
in their assessment, care and support planning and
review
• Integrated care licence condition applies to licensed
providers of NHS-funded services, including person-
centred delivery and engagement
• CQC: Health and Social Care Act 2008 (Regulated
Activities) Regulations 2014: Regulation 9 describes the
action to make sure that each person receives
appropriate person-centred care and treatment.

15. So why are ISFs important?
• According to ASCOF in 2018 on
average 71.5% of people in England
still have a council commissioned
service
• Direct Payments are great but not
everyone wants to be an employer,
manage a staff team and do admin
• There are often better ways to meet
outcomes than just using paid
supports – ISFs allow creativity and
innovation to blossom

16. • Place choice, control and power with people and families
• Nearly all the benefits of Direct Payments but without the
administrative burden of being an employer
• Providers can make adjustments to day to day support
without having to go back to social work teams or
commissioners (as long as it meets outcomes)
• Current contracts are mainly inflexible – they are also
wasteful
So why are ISFs important?

17. Direct Payment vs ISF

18. Impact of ISFs on Direct Payments
Source: Devon County Council MPS 2020

19. More traditional ‘market shaping’

20. Market shaping - community led
support
© TLAP
• Information & advocacy
• Socialising and fun
• Friendship and befriending
• Help in the home or garden
• Personal care
• Creative activities
• Sports and leisure

21. Main types of ISF Holding Organisations
• Neutral brokers i.e. Centres
for independent living,
Imagineer etc
• Support provider
organisations
• Small ‘micro providers’ with
less than 10 staff
sometimes acting as
umbrella coordination orgs

22. Work in other areas

23. Wiltshire CCG- accelerated ATU discharge

24. Wiltshire CCG –ISF approach
• Built a lifeplan with person and family
• ISF set at current ATU weekly cost (at start)
• Teams of PA’s (£27k ish) employed by provider organisation
• Rent cost subsidised by ISF – long term housing will be
purchased
• Profit lines separated into a percentage – not linked to hours
(anticipate reducing paid support as community life grows)
• ISF coordinator role in place
• Training by Studio 3 and LTF – paid by ISF
• 18 months of ongoing input by LTF to support settling in
• 1 person stuck in ATU’s for 8 years – has moved after just 8
months!

25. Moving from ‘support provider’
to ‘support broker’ with ISFs

26. Bristol City Council

27. Bristol – exploring ISFs, homecare
and community brokerage
© Simon Duffy

28. Essex County Council – taking a
whole system approach
• Place based offer (south
Essex)
• Community Catalysts
(Micro provider
development)
• CareMatch (north Essex) –
umbrella micro provider
coordinator
• Building a universal offer

29. Further Reading
https://www.skillsforcare.org.uk/D
ocuments/Events/ISF-events/IPC-
DCC-Individual-Service-Funds-
evaluation-report.pdf
https://www.skillsforcare.org.uk/Docume
nts/Leadership-and-
management/ISFguide/Individual-Service-
Funds-guide-Aug2020.pdf

30. Further Reading

31. https://citizen-
network.org/resources/
selfdirected-support-
network.html

32. Q&A

33. Contact us
To find out about how we can support you (no
matter at what stage you are it in developing an
idea) and information on our consultancy rates
please get in touch via email
at chris.watson@cforwr.org
Or telephone 07453 299057

34. Contact Us
Chris Watson, Self-Directed Futures/Centre for
Welfare Reform
chris.watson@cforwr.org
or
Chris.watson@selfdirectedfutures.co.uk