The Costs and Benefits of Personal Budgets for Older People: Evidence from a Single Local Authority

Abstract

The Westminster government in the UK remains keen to promote the use of personal budgets (PBs) in social care, as it believes these confer choice, empower the budget holder, and lead to greater levels of personalisation and better outcomes. This paper considers the costs and benefits of PBs—to local authority Social Services Departments, and to people using PBs, respectively—in a single English local authority setting. A comparative design was used to collect data from a large sample of ‘traditional’ social services users and a cohort of people who were using PBs as Direct Payments. Benefits relative to costs were compared using a statistical technique known as ‘bootstrapping’. The authors found that, compared to younger adults, older people did not greatly benefit from possessing a budget on the outcome measures used, but costs were higher for budget holders across all care groups. These findings support evidence from an earlier study (Glendinning et al., 2008) and raise important questions about the suitability of PBs as a means of achieving personalised services for older people and the implications for social work practice.

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