What do you need to know

about personal health

budgets? Jaimee Lewis with Martin Routledge

November 2012

Personal health budgets

• Where do they come from?

• How do they work?

• What happens next?

• Communicating PHBs

Personalisation - context

Personal health budgets are part of the broader drive to

personalise public services

Personalised

care

planning

Personal

health

budgets

Right to

Control

pilots

Special

Educational

Needs &

Disabilities

(SEND) pilots

Choice: of

provider, GP,

treatment and

Choose &

Book

Self-

directed

support

Social

care

personal

budgets

Context

PHB pilot programme

• Pilot programme ran until October 2012

• Over 2,700 people in the pilot

• A key group was people in receipt of NHS Continuing Healthcare but other groups were also included

• Independent evaluation results - imminent.

• In-depth study with twenty of the pilot sites explored how

best to implement personal health budgets, and who will

benefit most

• Five interim evaluation reports - by University of Kent

focused on early experiences of pilot project managers,

practitioners and budget holders and set-up costs

How does it work?

• Clinical staff and people planning together

• People and their PHBs

• The process

When might personal health budgets be useful

and how might people find out about them?

Care planning together

Thinking about personal solutions

Pete’s PHB

Pete has autism and type 1 diabetes. The move from

children’s to adult services was made easier for him

because of an integrated personal budget for health,

social care and education. Pete and his mum

Michelle chose carers that he has known since

childhood. His blood sugar levels need frequent

testing so his carer attends college with him to do

this, enabling him to continue his education. Pete has

also been able to stay living at home rather than

entering residential care, has more opportunities for

social interaction and is a happier young man.

Roger’s PHB

Then there’s Roger who has chronic obstructive

pulmonary disease. His breathing problems required

him to be admitted to hospital regularly, he is on

steroid medication and needs oxygen support

indoors. His personal health budget helps him

manage his condition better. He has purchased a

portable nebuliser so he can lead a normal life and

manage any attack as it happens. He is rehabilitating

through exercise, attending a local gym, using a Wii

Fit at home and gardening as he breathes better

outdoors. His health has greatly improved and he is

able to take less medication.

A bit of detail

Steps of the personal health

budgets process

Planning and managing the money

Spending the budget

• An individual with a personal health budget will be able

to spend it on a range of things to help them meet their

goals

• For example therapies, personal care and equipment

• People will not be able to pay for emergency care and

care they normally get from a family doctor

• Not allowed to spend the money on gambling, debt

repayment, alcohol or tobacco, or anything unlawful

Governance and risk

• The PHB partnership combines the professional’s vital

clinical expertise and knowledge, with the person’s

expertise in their condition and needs

• Clinical governance should support flexibility and

innovation where possible, so people can try new

approaches to achieving their health goals

• Health care professionals will continue to be focused on

securing the best health outcomes for people. Personal

health budgets can provide alternative ways of achieving

these, with people able to explore a wider range of

options in their care plan

Government is committed to

national rollout

National rollout from

2013-14 (an objective for the

NHSCB)

Right to ask for a

personal health budget

in NHS Continuing

Healthcare

(from April 2014)

Pilot

evaluation

(October

2012)

A wider right

to ask for a

personal

health

budget, for

those who

would

benefit

2012-13 2013-14 2014-15 […] longer-term aim

Next steps

• Department of Health has identified £1.5 million to support the first stage of rollout

• The funding will be used to support personal health budgets until April 2013.

• DH delivery team will support areas willing to “go further, faster”, along with wider implementation – active learning network

– regional events and networks: some hosted by SHAs, others by former pilot sites

• After this date, responsibility will transfer to the NHS Commissioning Board

PHB – the Communications

Challenge

• It’s the end of the NHS as we know it

• People will waste the money on treatments with no evidence

• It’s a foot in the door for vouchers and top-ups

• People don’t want to choose or control their health care –

they just want good local services and clinicians

• There is no market of different things for people to buy

• Its irresponsible placing extra burdens on people when they

are sick

• Doctors and nurses train for years for a reason

Exercise

• In pairs

• A challenge

• A positive response

• A question

Good practice toolkit • “Personal health budgets: Learning from the pilot

programme”

• Brings together learning from the DH’s personal health budgets pilot programme, and shows how personal health budgets can be implemented well

• For people working in the NHS or working with personal health budgets more widely, and people eligible for a personal health budget and their families

• Some parts of the toolkit aimed at particular groups such as frontline healthcare practitioners, or finance managers.

• Includes a communications toolkit with key messages & templates

www.personalhealthbudgets.dh.gov.uk/toolkit

More information

• Learning Network

www.dh.gov.uk/personalhealthbudgets

• NHS Choices

www.nhs.uk/personalhealthbudgets

• Peoplehub

http://www.peoplehub.org.uk/