Indirect Payments


This study investigated the practice of offering and administering direct payments for people who lack capacity.

From November 2009, a group of social care service users became entitled to receive direct payments for the first time – people who may lack capacity to consent. This new group of people included those with learning disabilities and dementia.

Direct payments can be made to other people as well as the service carer - for example, a carer or trusted family member - on behalf of the person lacking capacity. These 'suitable persons' manage the direct payment account for the service user with their best interests at the centre of all decisions.

We wanted to find out how direct payments are being offered and managed by these groups of people:

  • practitioners who deal with direct payments through their work
  • people asked to help manage a direct payment budget
  • people with either dementia or a learning difficulty who use social services and have a direct payment set up.

To do so, semi-structured interviews were used to explore experiences of direct payments in six English local authorities.

The research findings summary report can be accessed here. An online resource and free app were also created as part of the project.

The study was carried out by the Mental Health Foundation, in conjunction with the University of Bristol. Contact Toby Williamson, Head of Later Life at the Mental Health Foundation ( for further information about the project.