The initial brief for this project, previous reports, and new evidence about the current situation collected as part of this review, identified several challenges with the DFG:
- The increase in central government resources has not yet resulted in more people being helped due to reduced financial input from local authorities, lack of revenue funding, more complex cases and higher cost of work.
- Fear of triggering demand that cannot be met means that there is still little analysis of local needs and minimal advertising of the DFG. This makes it very hard for people to find out about the help available, particularly home owners and private tenants.
- The delivery process is often slow and cumbersome, with numerous handovers.
- The complexity of the DFG delivery system makes it hard for other professionals to understand it and reduces opportunities for preventative action.
- Restrictive upper limits on the cost of work and lack of contributions from health and social care can sometimes result in solutions that are not effective.
- Too many people drop out of the process, often because they must contribute to the cost.
- There is tenure inequity with a high proportion of grants going to registered providers when disabled people are increasingly in the private rented sector. The council stock remains outside the DFG which makes strategic planning more difficult.
- Reporting on outcomes is hindered by the heterogeneity of cases, staff time constraints and lack of data sharing, and this makes it hard to argue for additional resources.
- The Better Care Fund (BCF) and Health and Wellbeing Boards (HWB) could play a more strategic role but need to be focused on housing, not just on health and care outcomes.
- There has been a loss of information and advice services for people ineligible for the DFG.
- Changing expectations, new materials and advances in information technology mean the DFG needs to evolve if it is to remain relevant for the next decade and beyond.
- The challenge is to join up the process and shift the thinking from ‘welfare’ to ‘investment’ so that decisions are taken, not at crisis point, but in a more preventative way that is based on the long-term health and wellbeing of disabled people and their families.