Using Individual Service Funds (ISFs) to Improve Access to Self-Directed Support for Adults With Intellectual...

Area of Science:

• Disability Studies
• Social Policy
• Health Services Research

Background:

• Individual Service Funds (ISFs) in England are designed to provide self-directed support for adults with intellectual disabilities.
• However, their availability and effectiveness in offering choice and control compared to council-managed budgets are limited.
• This study investigates the factors contributing to successful ISF implementation.

Purpose of the Study:

• To develop a programme theory explaining how Individual Service Funds (ISFs) lead to successful outcomes for adults with intellectual disabilities.
• To identify key mechanisms and contextual factors influencing ISF effectiveness.
• To guide the development and implementation of ISFs.

Main Methods:

• A participatory realist review adhering to RAMESES publication standards was conducted.
• Programme theories were developed and refined using literature, expert stakeholders, and personal narratives (case studies).
• This approach facilitated an in-depth understanding of ISF implementation.

Main Results:

• Eight initial programme theories were identified, culminating in a comprehensive programme theory for ISFs.
• Key elements for successful outcomes include involvement in support planning, accessible budget information, and flexible budget use.
• Other critical factors identified were outcome-focused planning, dynamic support plans, non-traditional support, positive risk management, and trusting relationships.

Conclusions:

• The developed programme theory clarifies the causal pathways between ISF mechanisms, contextual factors, and successful outcomes.
• This theory provides a framework for improving ISF design and implementation.
• It empowers adults with intellectual disabilities to make informed choices regarding their support options.