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Personal Health Budgets: 10 features of an effective process

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 health budgets.

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.

Vidhya Alakeson

Last Updated : 12 September 2012. Page Author: Laura Bimpson.