With the continued implementation of the personalisation policy, Personal Budgets (PBs) have moved to the mainstream in adult social care in England. The relationship between the policy goals of personalisation and safeguarding is contentious. Some have argued that PBs have the potential to empower recipients, while others believe PBs, especially Direct Payments, might increase the risk of abuse.
This paper provides empirical evidence about levels of uptake of PBs and safeguarding referrals in England based on in-depth analysis of national data at aggregate, local council level in England, covering 152 Councils. This is complemented by analysis of 2,209 individual referral records obtained from three purposively selected study sites. The aim is to explore whether available data could provide evidence of association between the uptake of PBs and safeguarding referrals. Analysis of the national dataset found no significant relationships between PB uptake and the level and type of alleged abuse. However, analysis of individual-level referral data, from the three selected sites did find some significant associations particularly with financial abuse; and found the main perpetrators of the alleged abuse to be home-care employees. The findings are discussed within the context of current policy and practice.
Ismail, M., Hussein, S., Stevens, M. Woolham, J, Manthorpe, J., Baxter, K., Samsi, K. and Aspinal, F. (2017) Do personal budgets increase the risk of abuse? Evidence from English national data. Journal of Social Policy. 46, 2, 291–311.
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Founder and Director
Shereen Hussein is a Health and Social Care Policy professor at the London School of Hygiene and Tropical Medicine (LSHTM), United Kingdom.
Shereen Founded the MENARAH Network in 2019, through an initial grant from the Global Challenge Research Fund, UKRI. She is a medical demographer with expertise in ageing, family dynamics, migration and long-term care systems. Shereen regularly collaborates with the United Nations, the World Health Organisation and the World Bank in policy and research focused on ageing in the Middle East and North Africa Region.
Shereen received her undergraduate degree in statistics and a postgraduate degree in computer science at Cairo University. She completed an MSc in medical demography at the London School of Hygiene and a PhD in quantitative demography and population studies at the London School of Economics and Political Science, United Kingdom.
Director, Analytical Research Ltd, and Affiliate Research Fellow, Oxford Institute of Population Ageing, University of Oxford, United Kingdom
Mohamed Ismail is a quantitative researcher whose work develops mathematical and computational frameworks to better understand ageing dynamics and long-term care systems, with a particular focus on how time spent in care shapes future demand, costs, and system behaviour.
With a background spanning engineering, computer science, and mathematical finance, he brings a structured, model-based perspective to complex social challenges. His recent research focuses on duration-dependent processes, how individual-level dynamics translate into population-level outcomes, and the development of tractable models of ageing and long-term care.
His recent work includes the development of a new index-based framework for estimating long-term care needs in data-scarce settings, with evidence from the Middle East and North Africa, published in Population Health Metrics in 2026. His research also examines long-term care policies and financing in the region, including how care systems can be integrated into broader economic and social development strategies.
Mohamed began his career as a quantitative analyst with global financial institutions, including Merrill Lynch, HSBC, Mizuho Financial Group, and Credit Suisse, before transitioning to quantitative social research. In 2009, he founded Analytical Research Ltd, applying statistical and mathematical modelling to policy-relevant questions in ageing and care.
He has collaborated with academic and policy institutions across the UK, Europe, Australia, and the Middle East on research spanning population ageing, migration, and long-term care systems. His work appears in peer-reviewed journals and international policy reports, including contributions to reports by the U.S. Census Bureau, United Nations, World Bank, and World Health Organization.
Mohamed has been a core member of the MENARAH Network since 2019, contributing quantitative and interdisciplinary perspectives to research on ageing and long-term care in the Middle East and North Africa.
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