Using Individual Service Funds (ISFs) to Improve Access to Self-Directed Support for Adults With Intellectual Disabilities: A Participatory Realist Review.

Many included studies were derived from organisations keen to promote ISFs, which may have resulted in a positive reporting bias. The review focused on UK-based literature, though searches were extended to other care systems if few items were found, limiting generalisability to other national contexts. The complexity and variability of ISF implementations make it difficult to evaluate specific components independently.

The authors declare no conflicts of interest. The research was funded by the National Institute for Health Research.

Do not interpret this as evidence that ISFs are universally effective or superior to other funding models. The review explains the conditions under which ISFs work well, but the authors note that many providers currently lack the staffing and resources to meet these conditions, meaning the theory describes an ideal rather than a guaranteed outcome.