“The introduction of self-directed support has promoted a shift towards outcomes focused assessment and service provision, and necessitated a whole system approach to workforce development and commissioning / brokerage.”
- Local authority staff member
Self-directed support (SDS) aims to allow people to exercise an informed choice about how their support is provided to them. It is most commonly used in the delivery of social care and support but it can cover a much wider range of services.
The Social Care (Self-directed support) (Scotland) Act 2013, which was implemented in March 2014, requires local authorities to give people a range of options for how their social care is delivered, empowering them to decide how much ongoing control and responsibility they want over their own support arrangements. For example, through self-directed support people can choose to receive a direct payment to individually purchase the types of services and supports they require.
Significant impact for services
Self-directed support was highlighted by local authorities as having significant implications for the way in which services were or would be planned and commissioned in the future, in research conducted during production of the 2015 HIV Scotland report 'Making the vision a reality'. Service providers highlighted that there had been a decisive shift towards the creation of outcomes focused and person-centred services, with people having far greater control over the supports which they received:
“All contractual arrangements will be subject to development in light of self-directed support legislation.”
“As we have developed our assessments and resource allocation systems in line with self-directed support we are now working with support providers to revise how we commission support provision, as the purchasing power and direction gradually shifts from the local authority to people.”
“We are moving from conventional service based provision to person centred /outcomes focused support plans – now a statutory duty via the Self-directed Support Act.”
Self-directed support has also meant that services are less likely to be provided specific to particular conditions, with packages of support instead being tailored to meet individual needs regardless of the nature of a person's condition. This was seen by local authorities as a positive development with some commenting that it would also better enable gaps in service provision to be identified. It was also highlighted that a move away from more traditional forms of service provision makes it necessary to adopt a 'whole system' approach to workforce development and commissioning processes.
Future for self-directed support and people living with HIV
Local authorities have a key role in providing and commissioning services which are being accessed by people living with and at risk of HIV. It is still unclear how exactly the introduction of self-directed may impact on work and services in relation to sexual health and blood borne viruses. However, local authorities identified that, given the sometimes multiple and complex needs of people living with or at risk HIV, they stand to benefit from more person-centred approaches and greater control over their own support arrangements.