Direct Payments in Birmingham: Choice, Control and Flexibility

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Summary of report content

Healthwatch Birmingham investigated whether recipients of Direct Payments feel informed and supported by Birmingham City Council’s social care workers so that they can take control over the choice of services they access. Healthwatch Birmingham heard from 85 people across Birmingham using online questionnaires about their experiences of Direct Payments, including 37 service users, 34 carers, 4 third sector organisations, 1 individual services fund manager and 9 people who did not identify their affiliation.

The report found that clearer information from Birmingham City Council about their entitlements to Direct Payments is required. Service users and carers want to know what they should expect when they try to access, and then use, Direct Payments. In order to do this, frontline council staff need a clear understanding of Direct Payments, the support offered by services, targeted training and support to ensure that Direct Payment users receive consistent information and support. However, services users, carers and third-sector organisations all pointed to the complexity of the process and workforce capacity as factors affecting the timeliness of assessments and reviews.

Therefore, Healthwatch Birmingham concluded that Direct Payments may require a change in culture for staff at Birmingham City Council. It may require a shift in power, with recipients given more control and flexibility in their use of the funds. There has to be transparency and genuine collaboration with service users for Direct Payments to make a difference.

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General details

Report title 
Direct Payments in Birmingham: Choice, Control and Flexibility
Local Healthwatch 
Healthwatch Birmingham
Date of publication 
Thursday, 18 April, 2019
Date evidence capture began 
Monday, 1 October, 2018
Date evidence capture finished 
Tuesday, 31 December, 2019
Type of report 
Key themes 
Communication between staff and patients
Digitalisation of services
Information providing
Service delivery organisation and staffing
Healthwatch reference number 

Methodology and approach

Was the work undertaken at the request of another organisation? 
Primary research method used 
How was the information collected? 
If an Enter and View methodology was applied, was the visit announced or unannounced? 

Details of people who shared their views

Number of people who shared their views 
Age group 
Specific ethnicity if known 
Sexual orientation 
Does the information include public's views? 
Does the information include carer's, friend's or relative's views? 
Does the information include staff's views? 
Types of health and care professionals engaged 
Does the information include other people's views? 
What was the main sentiment of the people who shared their views? 

Outcomes and impact

Were recommendations made by local Healthwatch in the report? 
Does the information contain a response from a provider? 
Yes action has been taken or promised
Is there evidence of impact in the report? 
Not known
Is there evidence of impact external to the report? 

Network Impact
Relationships that exist locally, regionally, nationally have benefited from the work undertaken in the report
Implied Impact
Where it is implied that change may occur in the future as a result of Healthwatch work. This can be implied in a provider  response, press release or other source. Implied impact can become tangible impact once change has occurred.
Tangible Impact
There is evidence of change that can be directly attributed to Healthwatch work undertaken in the report.