The Impact of Direct Payments on Service Users Requiring Care and Support at Home

Background: Direct Payments (DP) is a service user-implemented scheme in which the individuals assessed as needing personal, social or health-related care services are given cash payments, allowing them to ‘buy in’ services they require. Previous research indicates DP offer the user greater control and flexibility over their care. However, the literature highlights problems with the system including user responsibilities, carer recruitment, provision of information and support. Aim: To examine the impact of DP on service users in a large Health and Social Care Trust, in Northern Ireland. Method: Thirty DP users from the Trust area were recruited to the study. The sample consisted of 2 respondents who were in direct receipt of DP, and 28 informal carers who implemented the budget on behalf of an eligible DP service user. Each respondent completed an interview with the study researcher, following an interview schedule devised by the research team. Results: Findings show service users are generally satisfied with most aspects of the scheme; however, difficulties still exist around provision of information, support, user responsibilities and public awareness. Conclusion: The research has led to recommendations that may allow the scheme to function more effectively, whilst ensuring user benefits remain largely unchanged.