Best Interest or Best Price – The Direct Payment Dichotomy [Video]

Last week Ted Foulger and myself were asked to attend a meeting with the manager of an NHS Complex Needs Service. The reason for the meeting was that a family were not happy with the training provision from the Complex Needs team because they felt it didn’t meet their needs or the needs of their son.

However, because the NHS fund their direct payment because their son has challenging behaviour they found themselves between a rock and a hard place in so much as the funding from the NHS was reliant on them using the NHS in-house training service that (in the opinion of the parents) wasn’t fit for service.

The problem is that because of the way the direct payments system is set up, the parents are the ones who are liable for the training provision they commission, not necessarily the NHS Complex Needs Team.

Therefore, we have a situation whereby a family is being pressurised into using something on the basis that if they didn’t they might not get funding!

Eventually, after three years of battling the new manager of the Complex Needs team agreed with the family that what they needed was something that was fit for purpose and in his words they are now “free to use whatever system they wish” because they are the ones who are fundamentally liable.

In short, the whole criteria of acting in the best interest of a service user seems to be down to the cheapest price.

Ted and I really felt for this family who had the courage to keep on going in spite of the continual obstacles placed in their way by the so-called caring agencies’.

They had been virtually beaten into submission by such a slow moving and ever changing process. At one stage it was compared to ‘climbing a hill of treacle with no end in sight’.

However, there was light at the end of the tunnel and thanks to Ted’s involvement – 35 years plus of NHS, mental health and learning disability  experience put to great use on that day, the family got what they finally asked for – the training they wanted.