This blog post has been written for us by Vidhya Alakeson, an
associate of In Control.
Vidhya Alakeson is the Director of Research and Strategy at the
Resolution Foundation, an independent policy and research
organisation. Vidhya also works part-time as a consultant focusing
on a range of policy and implementation projects related to mental
health, personalisation in public services and personal health
budgets. She currently co-leads for In Control the national
learning set for personal health budgets for mental health
supported by the Department of Health and the NHS Confederation.
She writes and presents regularly on personalisation and personal
We are now a month away from the publication of the final report
of the national evaluation of the personal health budgets (PHB)
pilot in England. If, as expected, the results are positive, the
Government will confirm its intention that every recipient of NHS
Continuing Healthcare (CHC) should have the right to ask for a
personal health budget from April 2014. The pressure will then be
on clinical commissioning groups to get their implementation plans
drawn up and to put the necessary infrastructure in place to meet
the 2014 deadline.
The findings from the national evaluation that have already been
published make it clear that much of the positive impact of
personal health budgets on people's lives depends on effective
implementation. The evaluation reveals that all too often PHB
holders did not know how much they had to spend before they started
planning; they did not know what spending rules were in place
locally; and they were not given a clear explanation of the reasons
why care plans were not approved.
Responding to these findings, In Control has been working with
commissioning groups and the Transition Alliance in the North West
to support the roll out of personal health budgets in the region
and ensure that PHBs are implemented in a way that makes the
process work for individuals, families, clinicians and
commissioners. The results of this work -
The 10 Features of an Effective Personal Health Budget Process in
Continuing Healthcare - are published today with
the aim of supporting commissioners regionally and nationally with
the implementation of PHBs.
Each of the 10 features identified in the report are important
but three deserve special mention. The first is that a personal
health budget for CHC should cover an individual's health and
social care needs, and should not be narrowly focused on clinical
needs only. Second, clinicians need to be involved from the outset.
PHBs are about respecting the lived expertise of individuals and
families but this expertise needs to be coupled with the knowledge
of professionals to ensure that clinical needs are met in ways that
fit an individual's wider goals and family priorities. Third, there
needs to be adequate upfront and ongoing investment to provide
individuals with the support they will need to plan how to use
their PHB effectively.
The clamour for PHBs has always been strongest in CHC so it is
to be celebrated that, as of 2014, families transitioning from
social care will no longer have to lose control when they qualify
for NHS support. With this first battle soon to be won, the next
challenge is to make sure that implementation happens in such a way
that individuals and families can get the most out of PHBs.