Eligibility First

The Social Services and Well-being (Wales) currently before the National Assembly for Wales is the most significant piece of legislation the institution has been asked to consider since gaining primary law making powers.

Scope, along with the whole third sector and especially our partners in the Social Services and Well-being Bill Advisory Group, has welcomed the opportunity presented by the new Bill.  The Bill will reform and integrate social services law and make provision for improving the well-being outcomes for people who need care and support, and for carers who need support. It will also increase co-ordination and partnership by public authorities to improve the well-being of people. It is therefore justifiably both broad and far reaching, covering a wide variety of issues and aspects.

However, there is one specific issue within the Bill which Scope and others are seeking more detail on – and that’s the issue of eligibility.

Indeed, the Bill’s success will very much be based on who is actually eligible to receive support through social care. If eligibility isn’t right, then issues of advocacy or regulation or anything else will not have meaning to many people because the simply will not be covered by the Bill.

We broadly welcome the intention to develop a national eligibility framework to ensure consistency across the country. It will set the criteria which local authorities will use to decide whether or not people will receive local authority funded care and support. It will be this framework that will determine the extent to which the Bill meets its objectives. The regulations will define what constitutes an eligible need and are absolutely critical to the working of the Bill.

Deputy Social Services Minister Gwenda Thomas is well aware of the importance of getting the eligibility criteria right. At the start of April she announced to the Health and Social Services Committee of the Assembly that the current eligibility criteria based on definitions of low, moderate, significant and critical levels were “past their sell by date.” She has promised instead to introduce the new national outcomes framework in early June.

In the new framework, Scope Cymru strongly believes that setting the threshold at the equivalent of the current “moderate” criterion is essential to achieving the aspirations of the legislation.

This would ensure disabled people receive not only the basic care and support they need, but also that they are able to take an active role in  their community – as set out by the definition of well-being in the Bill. If the national threshold were to be set at a higher level than moderate or its equivalent, the Bill would fail in its intentions to promote well-being.

Setting the threshold at “moderate” or its new equivalent is essential to ensuring that interventions take place when an individual’s needs are lower rather than their condition deteriorating. This is both beneficial to the individual and is an effective use of resources. Conversely, if the threshold is set too high, a larger proportion of people are likely to need more expensive services for a longer time period. Upcoming research set to be published which we have undertaken with Deloitte’s proves this point.

Beyond this too is the need to ensure that the new criteria are consistently applied.  Our experience suggests that interpretation of the current criteria varies widely between authorities. The Deputy Minister is well aware of this point and said that “the inconsistency that has developed between one authority and the other … is not sustainable.”

All of this is at the heart of the Bill, because unless you get eligibility right then you cannot ensure consistency and reach. Assessing individuals is directly related to this. There is an urgent need for all local authorities to adopt a standard approach and process when assessing and allocating resources to people’s social care needs. This would help to ensure consistency and equity across the country. A standard approach would be helpful for assessors, the individual, their families and carers and providers and would make the portability of assessments across local authority boundaries much easier.

We all want to live in a world of opportunity – to be able to live our own life, play our part and be valued for the person we are.

At Scope Cymru we’re passionate about possibility. It inspires us every day and means we never set limits on people’s potential. Getting the definition of eligibility right in the Social Services Bill is critical to realising this potential.

Ian Thomas is Director of Scope Cymru.