Supporting ‘Needs-Led’ Services: Implications for Planning and Management Systems (A case study in mental handicap services)

Abstract

ABSTRACTMany of the principles of the Community Care White Paper (DoH, 1989) bear a striking resemblance to the Welsh mental handicap strategy launched six years earlier (Welsh Office, 1983). This paper considers the lessons to be learnt from the Welsh strategy for the development of needs-led services as promulgated by the White Paper. Similarities and differences between the two policy initiatives are first identified before considering the conceptual basis of needs-led services. Attention is drawn to two interdependent dimensions of needs-led services, user participation and management delegation, as a means of depicting three underlying models, each with different value stances. By drawing from a case study of one area in Wales, an attempt is made to test the expectations for needs-led services in terms of local planning and management requirements of the three models against the experiences of those charged with putting them into practice. Implications for the White Paper are explored in connection with user involvement strategies and assessment and care management processes.