#OTalk – 11th February 2019 Direct Payments & Occupational Therapy.

This week Sherlyn Graham @sherlynmelody will lead the chat this is what she had to say

Direct Payments were set up with the Community Care (Direct Payments) Act (1996) and came into force on 1stApril 1997Direct payments were initially available only topeople 18 to 65 years with physical and sensory impairments, learning difficulties and mental health problems and who had been assessed as needing community care services. The Act was amended in 2000 to incorporate older disabled people and later in 2001 it was extended to 16- and 17-year-olds, parents of disabled children and carers.

The Act gave local authorities the power to make direct cashpayments to individuals.

A direct payment is a cash payment paid by a social services department to a service user to purchase services that meet their agreed social care needsDirect payments are the governments preferred mechanism for personalised care and supportThey were intended to empower service users giving them independence, choice and control by enabling them to commission their own care and support in order to meet their eligible needs.

For individuals, a direct payment can mean the difference between having to live in an institutional setting and having the assistance they want to be able to live in their own home.(Alzheimer’s society 2007)

To ensure the money is used for the right things, the direct payment is to be managed by the service user; where the service user is unable to do this for themselves they can be supported by a family memberfriend or an external advocacy organisation. 

As the money given to the service user is given in lieu of the local authority providing the care, the money remains public money. Therefore the use of the money is subject to scrutiny – audit. (TLAP 2019)

Direct Payments can be used to buy all or some of the support the service user needs to meet their needs howevereach persons needs are different and will vary from one case to the next. The money can be used to directly employ a personal assistant or hire care workers from a private domiciliary care agency. As an alternative to care services, the service usermay be able to use his or her Direct Payments to fund other local services that enable their independence within their own home and community, such as attending a day centre,accessing taxi cabs and meals on wheels.

According to the Royal College of Occupational Therapy (2019) Occupational therapy provides practical support to empower people to facilitate recovery and overcome barriers preventing them from doing the activities (or occupations) that matter to them. This support increases people’s independence and satisfaction in all aspects of life.

So as an occupational therapist how involved are you in using direct payments as a means of empowering people to engage in meaningful activities?


  1. What setting are you in and have you given a direct payment to any of your service users/carers?
  2. In general, what are your services users/carers using the direct payments for?
  3.  Have you used any external organisations to support with the utilisation of direct payments? And what support did they provide?
  4. What, if any, have you found to be the disadvantages of a direct payment?
  5. What have you found to be the advantages of a direct payment?
  6.  What have you found to be the main barriers and or facilitators of using direct payments.
  7. Do you find direct payment are more suited to a certain client group?


Legislation.gov.uk – Community Care (Direct Payments) Act 1996

Direct payments: answering frequently asked question – social care institute for excellence (2005)

Direct payments – information and guidance booklet, direct payments from Hertfordshire council for adult social care.

Direct Payments – Alzheimer’s society information sheet (2007)

Think Local Act Personal – Money management (2019)

The Royal college of Occupational Therapist – What is occupational therapy? (2019)

Post Chat Updates:

Online Transcript from HealthCare# Project 

PDF of Transcript: #OTalk 11 Feb 2020

The Numbers

1.048M Impressions
205 Tweets
37 Participants

#OTalk Participants

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