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All in-text references underlined in blue are added to the original document and are linked to publications on ResearchGate, letting you access and read them immediately. Personalisation and the Co-operative tradition Jenny Fisher1, Sue Baines2, Mary Rayner3 and Mike Bull4 Work in progress – not to be quoted without permission Abstract The agenda for „personalisation‟ is driving huge changes in public services for adult social care and health services in the UK, with profound implications for service users, commissioners, and providers. This paper is about the intersection of personalisation and the cooperative tradition, with its emphasis on mutual aid and value-led enterprise. Personalised services imply fewer block contracts between state agencies and providers, and more individual service users selecting and purchasing their own services either directly or through intermediaries. Funding systems designed to enable self directed support, in the form of direct payments and individual budgets, are established in social care provided by local authorities. They are novel in the National Health Service, where a pilot programme for personal health budgets was launched last year. According to the Department of Health there are new opportunities for innovative providers from any sector to offer the diversity of choice required by personalisation. The promises of personalised services include more choice, and solutions tailored for individuals but critics argue that the most disadvantaged are least able to exercise choice. Versions of personalisation encompass market models with service-users as customers, as well as more radical change in which they become co-designers and co-producers alongside professionals. For the former the key is a cash nexus, while progress towards the later involves finding new collaborative ways of working, sometimes breaking down distinctions between user, provider, carer, professional, employee, employer, and commissioner. The paper analyses these dynamics from the perspective of providers defined by co-operative values and principles, including employee owned co-operatives and new enterprises in which service recipients retain individual control over their care but share organisational burdens. 1 Senior Lecturer in Social Change, Manchester Metropolitan University Reader in Social Policy, Manchester Metropolitan University 3 Policy and Research Officer, Co-operatives UK 4 Research Fellow in Social Enterprise, Manchester Metropolitan University 2 Introduction Personalisation of social care and health is intended to ensure that that people can be responsible for themselves and make their own decisions about the services they need. It is an international phenomenon that includes moves towards greater selfdirected support and individualised funding. In this paper we are concerned with the agenda for personalisation in England. Personalisation implies less in-house provision, fewer block contracts between state agencies and providers, and more individual service users selecting and purchasing their own services either directly or through intermediaries. There are profound implications for service users, commissioners, and providers. Notions of independence, choice and control at the heart of personalisation are said to demand a shift of power to the service user. There is evidence that finding new collaborative ways of working is essential to making progress in personalisation within a context of public sector funding cuts and an ageing population (Carr, 2008; Dickinson and Glasby, 2010). Co-operatives are high on the political agenda and there has been growing interest across the political spectrum in the UK in how co-operatives might re-energise public services, in particular staff engagement, through forming employee owned co-operatives. In a recent document entitled „Building the Big Society‟ the new Coalition government states, "we will support the creation and expansion of mutuals, cooperatives, charities and social enterprises, and support these groups to have much greater involvement in the running of public services" (Cabinet Office, 2010). This paper is about the intersection of personalisation and the cooperative tradition, with its emphasis on mutual aid and value-led enterprise. First we describe and draw out key issues from personalisation in the context of local authority provided adult social care in England, which has been in place in various forms for more than a decade. Then we introduce personal health budgets, which were announced in 2008 and are currently being piloted (2009 and 2012). We go on to summarise the co-operative tradition and explore the values and principles underpinning the cooperative movement in the UK. After this we examine co-operatives‟ responses to personalisation with reference to case studies. In conclusion we discuss the potential implications and opportunities of personalisation for co-operatives, in particular its extension from social care to the National Health Service. Personalised social care Personalisation has been defined as “putting users at the heart of services, enabling them to become participants in the design and delivery ....[so that]... services will be more effective by mobilising millions of people as the co-producers of the public goods they value” (Leadbetter, 2004: 19) cited in Newman et al (2008). Personalisation is not a political fad but a set of principles for reform espoused by the previous New Labour government and the recently formed Coalition (Dickinson and Glasby, 2010). The promises of personalisation are for choice, control, and solutions tailored for individuals, taking account of their strengths, preferences and networks of support and resources (Carr, 2008). Its origins were in the struggle of physically disabled people for control over the support they needed to live independently (Office for Disability Issues, 2008; Glendenning et al, 2008). Personalisation has been described as a philosophy underpinned by notions of a shift in the balance of power, responsibility and resources from state agencies to individuals (Glasby and Dickinson, 2010). Service users are not mere beneficiaries but the commissioners of their own care, selecting and buying what they decide will best meet their particular needs (Bartlett, 2009). More radically, they become active participants in the construction, production and management of their own services. Another way of talking about this reform is the “transformation of citizens into both managers and entrepreneurs” (Scourfield, 2007: 112). Personalisation is enabled by, and usually associated with a set of mechanisms employed to try and bring it about (ibid). These mechanisms in England have involved the transfer of financial resources to individuals in place of the provision of services:       Direct Payments (DPs) are cash payments made in lieu of social service provisions, to individuals who have been assessed as needing support. Pressure groups for the rights of people with physical impairments lobbied vociferously for direct payments (Shakespeare 2000). They were introduced for adults between the ages of 18 and 65 under the Community Care (Direct Payments) Act 1996 and subsequently amended in 2000 to include older people. Personal budgets were introduced originally for learning disability service users to control their social care budgets. They were spearheaded by In Control, a national social enterprise set up in 2003 by the Department of Health, several local authorities and Mencap (a national charity). In 2005 they were extended to other groups including older people. Individual budgets were introduced in 2006 initially in thirteen Department of Health pilots. These can be used to purchase local authority or private services. Individual budgets differ from personal budgets in that they are intended bring together all the various funding available to the individual including for example housing benefits and support for employability. By March 2011, all local authorities in England are required to have moved at least 30 per cent of people who use publicly funded adult social care onto personal budgets. The most popular option under personal budgets has been direct employment of personal assistants. It is also possible to receive personal budgets through a managed account, held by a provider, allowing people to direct their own care without having to actually manage it. This has proved popular with older people. The Welfare Reform Act 2009 gives individuals the right to be told the monetary value of certain support they are eligible to receive, and is intended to deliver choice and control over how those resources are used Personalisation in the form of these models of self-directed support has been evaluated by academic research teams commissioned by the Departments of Health and In Control, as well as by think tanks Demos and the Kings Fund. Overall, evaluations have found that while uptake has been slow and indeed still is, especially among older people, those who do use personalised services consistently report satisfaction and improved experiences of care. Benefits to individuals include improved quality of life, increased control and independence, greater continuity of care, and fewer unmet needs (Glendenning, 2008). Older people, however, were an exception and reported lower psychological well-being (ibid.) Effective use of public money by avoiding waste in providing services people don‟t value is also recorded as a significant achievement (Hutton and Waters, 2008). It has been countered that evaluations based on personalisation pilots have tended to exaggerate gains because participants were selected for being unhappy with their existing services (Bartlett, 2009). A survey of potential, rather than actual, adopters of personalized services concluded that too much emphasis is placed on the changes that people will make, especially older people (ibid. 2009). Some research based commentary argues that enthusiasm for the benefits of personalisation should be tempered by a number of concerns beyond the rates of take up, for example, that the most disadvantaged are least able to exercise choice (Ali, 2009) Moreover, with the focus of personalisation upon the wishes of those individuals who do exercise choice, there is a danger that collective service provision will be undermined. Manthorpe et al. (2009) warn that people using services could become isolated and that the power of the collective voice on commissioning, shaping, developing and regulating services might be lost. The direct payments user has been described as a strange hybrid construction being a „citizen-as-consumer-as-service-user-as-employer‟ (Scourfield, 2005; 481). There is the potential for exploitation in the employer – employee relationship and the employee is isolated from opportunities for training, improved status and negotiation of working conditions. Tom Shakespeare, a high profile campaigner for disability rights, acknowledgesthat, while direct payments were important for the independence and empowerment of disabled people who need support, there are serious dangers for carers in „an unreflexive reliance on a servant/employer solution‟ (Shakespeare, 2000:63). Not all service users are willing or able to take on the role of employer. This can be seen as a business opportunity for intermediaries interested holding budgets for people who don‟t want to manage them, and acting as brokers to design person-centred plans for people (Bartlett, 2009). Overcoming the sense of powerlessness without taking on employment responsibilities would involve moving beyond market-based solutions of personalization theory according to Fergusson (2007) who argues for the development and strengthening of collective organisation both amongst those who use services and amongst those who provide them. Personalisation is premised on the devolution of power to individual service users exercised through a competitive market (Carr, 2008). It is intended to lead to changes in demand for existing services, provide a stimulus to revise the way services are organized and indeed potentially bring about transformation in the market. According to the Department of Health there are new opportunities for innovative providers from any sector to offer the diversity of choice required by personalisation. Local markets in many areas, particularly rural areas, however, provide only limited choice (Carr 2008). Genuine choice and control will not be improved in the absence accessible, diverse and affordable service options (Glendenning 2008). To deliver on the promises of personalisation, there is a need for a much enhanced supply side “made up of large, small, private, not for profit, and public providers competing fairly with each other” (Bartlett, 2009: 8). The risk of a provider market failing to meet users‟ expectations and a lack of Personal Assistants could lead to frustration and disappointment, or even fraud and abuse (Manthorpe et al. 2009). The evidence is that the provider market for personal care is as yet undeveloped. It is unclear which types of organisations will wish or be able to seize opportunities to supply the market. Some commentators have challenged the individualism at the heart of personalisation. It has been described as „neoliberal recipe of empowerment as consumers individually spending public money‟ (Burton and Kagan, 2006) and that risk is transferred to individuals who may find the burden too much and lack access to good information about the provider or quality of service (Newman et al, 2008). Burton and Kagan (2006) argue that “the perfectly sound idea that arrangements should be built around the person, rather than the person fitted into services, is elevated into a kind of strategy for service reform” and suggest that there needs to be an integrated approach to social policy that has at its core the building of local communities and their local economies, with democratic governance and a focus on culture rather than consumption. Overall the evaluations and commentary of personalisation of social care highlight concerns and tensions around: choice and control for service users; the lack of accessible and affordable providers; employee working conditions; quality issues; and the direction towards individual consumer models which can be seen as potentially depleting collective wellbeing. Multi-stakeholder co-operatives have been proposed as one way of addressing these issues (Scourfield, 2005). Personal health budgets Personalisation in health as in social care aims to give people increased control over the services they use by putting them at the centre of the decision-making process. This is in line with patient choice being one of the main driving forces in English health policy. The King‟s Fund (2009) maintains that there are ambiguities about how they will work and states “They are modelled on individual budgets and direct payments in social care, but unlike social care, the NHS is a universal system.” Further they highlight concern over a possible increase in inequities in health (it is expected that there will be higher take up from younger people and differences in quality of services) A pilot programme for personal health budgets was launched last year in a government review of the future of the National Health Service (Darzi, 2008). Initially PHBs are aimed at patients who have long-term health issues and not for acute services. Indeed in his report Darzi (2008) states, “Personal health budgets are likely to work for patients with fairly stable and predictable conditions, well placed to make informed choices about their treatment; for example, some of those in receipt of continuing care or with long-term conditions”(p 42). However end of life care and maternity services are included. There are six key principles of PHBs as outlined in High Quality Care for All (Darzi, 2008). These are: upholding the values of the National Health Service; quality of care is central to the process; tackling inequalities and protecting equality; PHBs are voluntary; decision making to be as close to the individual as possible and; partnership and co-production are fundamental. In 2010 the Department of Heath identified seventy pilot sites in England and these are now underway and will run until 2012. The national evaluation will mainly focus on twenty of the pilots who will be studied in-depth and there will also wider research exploring the potential role of personal health budgets for a number of client groups and service provision, including maternity and end of life care provision. In addition there will be local evaluation. The twenty pilots to be evaluated in-depth were selected based on their larger target numbers and inclusion of clients with disabilities. PHBs are not means tested and there is no link to unemployment or other government funded benefits. There will be three different categories of PHBs. Notional personal budgets where patients are aware of the treatment options and financial implications of their choice within a limited budget. No direct payments are made and the Primary Care Trust is responsible for the contract and service coordination. The second category is real budgets. These involve an amount of money being identified that is held by a third party who could be the General Practitioner on behalf of the patient. The third party can support the patient with choice of services. Finally there are direct payments, and the patient will have a cash amount to purchase and manage healthcare services. Previously handing money directly to patients for healthcare has been illegal. However the Health Act 2009 authorised the twenty in-depth pilots to establish direct payments to clients while the other pilots can apply to the Secretary of State for the approval to do the same. Until an application is approved they will have to make payments through a third party or notional payments. PHBs are about more than giving people money to purchase the support they need and requires a seismic organisation shift in culture and systems and increase in flexibility. They have the potential to shift the focus from process or treatment to outcome. Information available on the progress of the pilots is limited and has been difficult to obtain for this paper. Self directed models following principles of personalisation are novel in health and perhaps more of a challenge in the National Health Service given the principal of free service at the point of use. The potential for the market is as yet unknown and as in social care there may be new opportunities for various kinds of provider models, for example, large national corporations, micro community enterprises, and co-operatives. It is to the co-operative tradition that we now turn. The co-operative tradition The United Kingdom‟s co-operative movement is a membership based movement with two centuries of experience in bringing people together to work towards both social and economic empowerment. The first successful modern type of co-operative was set up in Rochdale in 1844 when a group of 28 artisans in the town of Rochdale, in the north of England established the first modern co-operative business, the Rochdale Equitable Pioneers Society. The weavers faced harsh working conditions and low wages, and they could not afford the high prices of food and household goods. They decided that by pooling their scarce resources and working together they could access basic goods at a lower price (Birchall, 1994; ICA 2005). The model was widely copied, with many adopting the Pioneers' values and principles which have since become the basis for co-operatives globally (Birchall, 1997). In England, consumer co-operatives grew rapidly and provided not just economic democracy and a financial dividend but a range of educational and social opportunities for their members. Co-operatives have provided an effective and ethical alternative to conventional business models since then. Whilst consumer co-operatives, most notably The Co-operative Group, are the most high profile in the UK, the flexibility of the co-operative model has resulted in its application across many different sectors of the economy. These include housing, health and social care, financial services, childcare, leisure, agriculture and manufacturing for instance. Recently, community ownership of enterprises such as local shops and renewable energy projects, using the co-operative model, has grown as its ability to embed community participation and control has been increasingly recognised. A thriving co-operative economy already exists in the UK. There are 4,800 co-operative businesses, owned by 11 million people - one in five of the population and sustaining more than 200,000 jobs. Employee ownership has demonstrated its economic worth in the UK too: the share prices of public companies that are more than 10% owned by employees outperform the market as a whole by on average 10% per annum (Field Fisher Waterhouse, 2009). Since the early 1990s the co-operative model has been adapted for the public sector, for instance the Trust model as applied to hospitals and schools. In some cases these adaptations were responses to the Thatcher government‟s privatisation programme and the opening up of public services to competition. Traditional Cooperatives and mutuals operated for the public good by enabling people to have access to goods and services that were not provided by the market or by the state (Mills and Griffiths 2009). Their self-help business model struggled to survive in the latter part of the 20th Century, but they have recently come back into public awareness as confidence in both state and investor ownership has declined (ibid.) A range of health and social care co-operatives already exist – some owned and run by their employees but others involving a range of people including services users, carers and the local community, known as the multi stakeholder model. At least forty co-operatives have been identified as actively delivering health and social care services across England. Service provision mainly centred within the home care sector, General Practitioner and Primary Health care, foster care and nursing services. Internationally the use of the co-operative model in health and social care sectors is well established (Girard, 2002; Health Victoria, 2009) The way that co-operatives do business is driven by a set of values and principles. These are set at an international level and overseen by the International Co-operative Alliance. Defined within the Statement on the Co-operative Identity, the values are: “…self-help, self-responsibility, democracy, equality, equity and solidarity. In the tradition of their founders, co-operative members believe in the ethical values of honesty, openness, social responsibility and caring for others.” A number of principles guide how these values are put into practice. For instance the first principle, „Voluntary and Open Membership‟, states: “Co-operatives are voluntary organisations, open to all persons able to use their services and willing to accept the responsibilities of membership, without gender, social, racial, political or religious discrimination.” (ICA, 1995) Case studies Sunshine Care in Rochdale, England, is a workers‟ co-operative, developed by a group of home care workers previously employed by the local authority. Established in 2008, the organisation was one of the Direct Payment pilot projects and a pilot of the „Self-Managed Care – a co-operative approach‟ programme. The initial founders were concerned about the potential impact of personalisation on their clients (care provision by the private sector) and their own pay and working conditions. They wanted to be able to influence the care they provided and enable employees to shape the organisation they worked for. One of the founders had a wealth of experience as a community activist and was confident of what support she and her colleagues could access. Networking skills (gained though a lifetime of community activism) were an important resource for Sunshine Care. They are now registered with the Care Quality Commission, a regulatory body, have five customers and employ two personal assistants. However the establishment of the co-operative has taken a long time. A director states ”it has been a challenging and hard struggle throughout, everything including setting up the company has been difficult”. Local councillors have supported the organisation but with a political change in the councillor responsible for Social Care this relationship is uncertain. Sunshine Care received a grant from the local authority (though this process was prolonged) that enabled the organisation to set up an office and they have received some support from business start up organisations. It is evident that the mainstream business support organisations can struggle with supporting co-operatives as they do not fit the standard company limited by guarantee model. Currently Sunshine Care is facing new challenges. The local authority is behind with Direct Payments and there are no forms available for potential customers to apply for a payment. Social Care department staff have changed again and Sunshine Care have lost their departmental contacts. Their major challenge now is to recruit customers and employees. A key constraint is the local authority‟s provider lists. Sunshine Care is not a „preferred‟ provider for Rochdale or other local authorities thereby reducing their potential customer base and at odds with the promises of personalisation and the choice agenda. The organisation is unique in the local authority and this is cited as an issue. If there were other co-operatives then care assistants could be shared to cover staff absence. Efficiency vs empowerment The local authority has an e-monitoring system for all care workers designed to provide an efficient management process. The worker has to phone a number on arrival to register their arrival and to ensure that the care job is logged on a system. According to Sunshine Care this is an impersonal process at odds with their values of empowering the customer through signing for their own care. A director considers that the co-operative basis of the organisation is of particular importance to the employees and of resonance for older people in the area where there is a strong tradition of the co-operative movement. This may become a key marketing focus for customers but may not be a priority for the local authority, bringing us to the crucial point of who is the customer in social care provision? Caring Support, in Croydon, England is a multi stakeholder co-operative established by service users and carers, both paid and unpaid. Like Sunshine Care the organisation was one of the Direct Payment pilot projects and a pilot of the „SelfManaged Care – a co-operative approach‟ programme. It is registered with a regulatory body and has begun trading with customers who have direct payments and self-funders. The majority of board members are service users and the organisation uses a cluster-based operational model. Care is provided by personal assistants for a group of service users in a geographical location. According to the founders the organisation provides a high quality service that is underpinned by employees and service users having an influence over the provision and feeling empowered and involved. All employees are trained by the organisation and the ethos and values of co-operatives are central. Advantages of the cluster model include a reduction in travel expenses and time for carers, development of a longer term relationship between user and carer and flexibility to cover holidays and sickness. Conclusions and discussion The implementation of personalisation in social care is incomplete. Its extension to the National Health Service is at pilot stage and to date there is no evaluation of the pilots. This paper has explored the personalisation mainly from the experience and analysis of adult social care in which individuals take control of financial support received from the state. We have considered lessons that have been learned from evaluation and research, for example the need to develop a provider market. We have also noted from this literature issues that are uncertain and sometimes highly controversial. Particularly contested are the status and working conditions of employees, and fears that individual empowerment through consumer models risks depleting possibilities for collective action and democratic accountability (Burton and Kagan, 2006; Newman et al., 2008). Against this background, providers defined by co-operative values and principles, seem well placed to begin to resolve such tensions through developing collective approaches and developing new services. Some case study evidence has demonstrated that co-operatives already operational in the area of social care are providing a collective and community based service. The central tenets of personalisation, choice, empowerment and involvement, are firmly rooted in the origins of the case studies and inform their operation and values. Employees benefit from being able to influence the organisation and there are opportunities for working in innovative and new ways. Customers / users who are members can shape the service provided according to their needs. The co-operative workers in the case studies have extensive contacts and excellent networking skills. Networking to mobilise resources for a venture with an uncertain future has been identified a fundamental part of entrepreneurial behaviour in studies of entrepreneurship and small business (Dubini and Aldrich 1991; Chell and Baines 2000). For some worker co-operatives, skills gained through community activism could have important implications for the success of their enterprises. However there are challenges and constraints for embryonic and existing health and social care co-operatives. Business support is seen as limited to standard models that do not fit with co-operatives and funding for support is difficult to obtain. Despite the rhetoric of central and local government documentation it appears that the reality for providers and service users is different. There is evidence that delays in making direct payments to recipients by local authorities result in uncertainties in salary payments and other commitments for small organisations. This is a typical cash flow issue for all small businesses, but exacerbated by the individualised nature of the personalised budgets and direct payments. There is potential within social care and health for different kinds of co-operative and mutual enterprise, including employee and worker owned co-operatives, and new enterprises in which service recipients retain individual control over their care but share organisational burdens. Personalised care and health imply revising how people and communities work together in ways that are both welcomed and feared and integration of the health and social aspects. Lessons from co-operatives operating within the social care sector will prove valuable for engaging with personal health budgets but while it is too early to confidently assess the opportunities that these will offer to new enterprises, it is likely that change will be gradual. Cooperatives are likely to be among many kinds of enterprise capable of offering a way forward and given current political landscape in England are ideally placed to seize the opportunities personalisation offers. Contact: Jenny Fisher Senior Lecturer Manchester Metropolitan University j.fisher@mmu.ac.uk References Ali, AM (2009) The personalisation of the British National Health Service: empowering patients or exacerbating inequality? International Journal Of Clinical Practice 63(10): 1416-1418. Bartlett, J. (2009) At your service: navigating the future market in health and social care, London : Demos. Birchall, J (1994) Co-op, the People’s Business Manchester: Manchester University Press. Birchall, J (1997) The international co-operative movement Manchester: Manchester University Press. Brewis, R., Duffy, S., Fitzgerald, J., Hodgkin, P. and Wate, S. (2009) Citizenship in Health In Control Discussion Paper Draft Version 2 Available at: [Accessed 1 June 2010] Burton, M. and Kagan, C. (2006) „Decoding valuing people‟, Disability & Society, 21(4), pp. 299–313. Cabinet Office (2010) Building the Big Society Available at: http://www.cabinetoffice.gov.uk/media/407789/building-big-society.pdf [Accessed 1 June 2010] Carr, S. (2008) Personalisation: a rough guide, SCIE http://www.scie.org.uk/publications/reports/report20.asp [Accessed 1st June 2010] Chell, E. and Baines, S. (2000) Networking, entrepreneurship and microbusiness behaviour. Entrepreneurship and Regional Development 12(3), 195 – 215. Co-operatives UK, 2009. Co-operative Review 2009. Darzi, (2008) High quality care for all: NHS Next Stage Review final report Norwich: The Stationery Office. Available at: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/document s/digitalasset/dh_085828.pdf [Accessed 26 May 2010] Develtere,P., Pollet, I., and Wanyama, F (2008) Co-operating Out of Poverty; The renaissance of the African Co-operative Movement Geneva: ILO and World Bank Institute. Dubini, P. and Aldrich, H. 1991 Personal and extended networks are central to the entrepreneurial process Journal of Business Venturing, 6: 305 - 313. England. Health Act: Elizabeth II Chapter 21(2009) London: Office of Public Sector Information. Dickinson, H. and Glasby, J. (2010) The personalisation agenda: implications for the third sector, Third Sector Research (Centre Working Paper 30): Birmingham Ferguson, I. (2007) „Increasing user choice or privatizing risk? The antinomies of personalization‟, British Journal of Social Work, 37(3), pp. 387–403. Field Fisher Waterhouse, 2009. UK Employee Ownership Index: Employee owned companies continue to outperform the FTSE All-Share as third quarter of 2009 sees employee owned company shares up 27.6%. [Press release] 29 October 2009 Available at: http://www.equityincentives.co.uk/documents/library/Employee-ownedcompanies-Oct2009.pdf [Accessed 6 May 2010] Girard, Jean-Pierre (2002) “Social cohesion, governance and the Development of Health and Social Care Co-operatives”, Review of International Cooperation, vol. 95, no 1, p. 58-64. Glendinning, C. (2008) Increasing Choice and Control for Older and Disabled People: A Critical Review of New Developments in England, Social Policy & Administration, 42(5) 451–469 Hutton, C. and Waters, J. (2009) Evaluation: In Control‟s Second Phase, London: In Control. Health Victoria 2009 Co-operative Health Overseas http://health.victoria.coop/news/6-co-operative-health-overseas (Accessed 7 May 2010) International Co-operative Alliance, 1995. Statement on the Co-operative Identity. [Online] (Updated 26 May 2007) Available at: http://www.ica.coop/coop/principles.html [Accessed 6 May 2010] International Co-operative Alliance, 2005. Co-operative History: the Rochdale Pioneers. [Online] (Updated 21 July 2005). Available at: http://www.ica.coop/coop/history.html [Accessed 6 May 2010] King‟s Fund (2009) Personalisation [Online] Available at: http://www.kingsfund.org.uk/topics/personalisation/index.html [Accessed 26 May 2010] Leadbeater, C. (2004) Personalisation through participation: A new script for public services, London: Demos McIntosh, K. (2009) „Personal Health Budgets: the patient is always right‟ Health Service Journal. pp20-22. 5 March 2009. Mutuo, 2009. Mutuals Yearbook 2009. Manthorpe, J., Jacobs, S., Rapaport, J., Challis, D., Netten, A., Glendinning, C., Stevens, M., Wilberforce, M., Knapp, M. & Harris, J., (2009), 'Training for change: early days of Individual Budgets and the implications for social work and care management practice: a qualitative study of the views of trainers', British Journal of Social Work, 39(7): 12911305. Mills, C. and Griffiths, R. (2009) From State to Community Ownership: Transforming NHS Community Services, Birmingham: Cobbetts Newman, J., Glendinning, C. and Hughes, M. (2008) „Beyond modernisation? Social care and the transformation of welfare governance‟, Journal of Social Policy, 37(4), pp. 531–57. Reed, D and McMurty (2009) Co-operatives in a Global Economy Newcastle: Cambridge scholars publishing Scourfield, P. (2005) „Implementing the Community Care (Direct Payments) Act: Will the supply of personal assistants meet the demand and at what price?‟, Journal of Social Policy, 34(3), pp. 469–88. Scourfield, P. (2007), Social care and the modern citizen: client, consumer, service user, manager and entrepreneneur, British Journal of Social Work, 37, 2: 107–22. Shakespeare, T. (2000), „The social relations of care‟, in G. Lewis. S. Gewirtz and J. Clarke (eds), Rethinking Social Policy, London: Sage. Spandler, H. (2004), „Friend or foe? Towards a critical assessment of direct payments‟, Critical Social Policy, 24: 2, 187–209. Williams, B., Copestake, P., Eversley, J. and Stafford, B. (2008) „Experiences and Expectations of Disabled People: A research report for the Office for Disability Issues‟, at: http://www.odi.gov.uk/docs/res/eedp/eedp-full-report.pdf View publication stats