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Living on a knife edge: The responses of people with physical health conditions to changes in disability benefits. Disability and Society.

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Care management is a central part of the current health and social care system, but the development of Self‐Directed Support raises significant questions about the future of this function. Moreover, if the current design of the care management function is to change, then this will raise significant challenges and opportunities for those professionals who currently act as care managers. These changes may even allow social workers to return to a way of working that fits better with their professional ethos.

This article reviews the social care evidence concerning direct payments/personal budgets, before arguing for an extension of these concepts to the National Health Service (NHS). Despite a commitment to inter-agency health and social care, direct payments/personal budgets have only been available for the ‘social care’ part of people's lives. Moreover, many of the challenges faced by the NHS are precisely those which social care has turned to more individualised funding to help resolve. Against this background, the article speculates as to how such a system might work and seeks to address some popular misconceptions and potential objections.