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New Report: Personal Health Budgets for Continuing Healthcare

A new paper has been published by In Control highlighting the 10 features an effective process for personal health budgets for continuing healthcare.

The paper was funded by the North West Transition Alliance and produced in partnership with NHS North West. It is part of a broader programme of work with primary care trust (PCT) clusters in the North West to help support them for roll out of personal health budgets in 2014. It draws on the learning of pilot sites in the region and nationally to outline the 10 features of an effective personal health budget process within NHS continuing healthcare.

Author of the report, Vidhya Alakeson, comments: "Through our work in the North West we have established that the current pilot programme has not been driven by a blueprint for how personal health budgets should be implemented and, therefore, there is a significant amount of variation in how the process has been designed and the outcomes have been achieved for people.

"In identifying the features of an effective process, the report intends to inform future implementation to ensure that personal health budgets deliver the best possible outcomes for individuals and families.

More than 70 PCTs have been involved in piloting personal health budgets over the past three years, of which 20 are taking part in an in-depth, controlled evaluation. Pilot sites have implemented personal health budgets across a wide range of long-term conditions, including mental health problems, diabetes and chronic obstructive pulmonary disease and within certain service areas and funding services such as maternity services, end of life care and continuing healthcare.

Based on early evidence of positive impacts, the Secretary of State for Health committed to roll out the right to ask for a personal health budget in continuing healthcare from April 2014 in advance of the official publication of the national evaluation in October 2012. The 2012/13 NHS Operating Framework, therefore, instructs PCT clusters to prepare for roll-out. Local implementation of personal health budgets should be included as part of the planning for the transition from PCT clusters to clinical commissioning groups.

The 10 features of an effective personal health budget process for NHS continuing healthcare highlighted in the report include:

  1. A personal health budget covers the full range of an individual's health or social care needs
  2. The full continuing healthcare package is included within a personal health budget
  3. Individual's know how much they have to spend before they start planning
  4. The indicative budget process is based on needs not hours of care
  5. Clinicians are involved from the very beginning but do not dominate
  6. Adequate support is available to personal health budget holders for support planning
  7. The support plan is written in an individual's own words and is not a clinical care plan
  8. Individuals are in charge of decisions about training
  9. The approval process is light touch and transparent
  10. There are adequate options available for how the personal health budget is held

"Personal health budgets require significant culture change in the NHS to succeed but many of the pilot sites have demonstrated that this is possible. In those areas that have gone the furthest, personal health budgets have become the norm in continuing healthcare - they are how continuing healthcare is done locally, although the option not to have a personal health budget remains," continues Vidhya.

The paper is available to download below.

Vidhya Alakeson has written a blog post for us on the report and this can be read here.

We are also hosting a webinar on the paper on 7 November at 10am. The session will be presented by Vidhya. To register for a place, please email communications@in-control.org.uk

This week we have also published a paper on the implementation of social care personal budgets in the North West.

7 comments for “New Report: Personal Health Budgets for Continuing Healthcare”

  1. Gravatar of Nick PahlNick Pahl
    posted 14 September 2012 at 15:15:49

    Thanks for this Vidhya - very useful.

    Im pleased you say that an effective choice of options should be available - point 10

    People also want personal budgets to be non -bureacuratic and allow them to use professionals in a way that meets their needs - for example for British Acupuncture Council members for acupuncture.

  2. Gravatar of Sam varleySam varley
    posted 23 September 2012 at 19:33:23

    hi you make some very goods points you are right a personal health budget should cover the full range of an individual's health and social care needs, not hours of care. Clinicians should not dominate the support plans.

    unfortunately there are not always adequate options available to the individual when they need continuing healthcare, budgets are tight and inflexible.

    I run a small domiciliary care service. we do not contract with social services, all our service users are either private, use direct payments or use personalised budgets.

    we have many services users whom we have supported for many years. As their health needs deteriorate they become eligible for continuing care funding, the council then informs them that if they choose to be funded by NHS continuing healthcare they must loose their carers that have been caring for them for a very long time, they must use a company that has a framework or contract with them.

    This is not choice, it does not take into consideration that a vulnerable person who has become dependent on a familiar carer at a very sensitive needs continuity.

    For example a lady who has dementia was transferred over to NHS continuing health care funding recently, staff that are now caring for her had to contact her former carer who had looked after her for many years to ask what was the lady trying to tell them as they could not understand her and that she was becoming distressed.
    Is this any way to treat a vulnerable person on the basis of contract, budgets, or who has or does not have a framework with them?
    your 10 point plan is good in theory I hope it works out in practise

  3. Gravatar of Adam HuszczaAdam Huszcza
    posted 30 October 2012 at 09:06:35

    Hi - in relation to "feature #1", 1. A personal health budget covers the full range of an individual's health or social care needs.

    ... together with the notion that "the PHB process starts after eligibility is confirmed ...

    I believe that particularly for CHC clients the PHB process should begin at the point of referral - rather than after eligibility is confirmed. The CHC Individual Needs Portrayal (information collection process) seems to be ideal for capturing health and social care "Outcomes" as well as needs.

    Interesting to hear how others have mainstreamed PHBs into the National Framework.

  4. Gravatar of Matt GillamMatt Gillam
    posted 18 November 2013 at 12:47:22

    Adam, I am inclined to agree with you, in that PHB consideration should be an intrinsic part of a needs assessment; the outcome of which will determine whether eligibility is met, or not. The downside may be that someone who is deemed not eligible, may be looking forward to an innivative and fresh approach to needs-led care.
    Sam, certainly round my way, transfer from Local Authority provision to NHS provision does not involve changing the provider, unless the provider is no longer deemed to be suitable, due to deterioration of the person, OR because the provider is comparibly too expensive to be able to afford the provision.

  5. Gravatar of BRIAN WARDBRIAN WARD
    posted 27 September 2014 at 22:37:54

    hi,
    Please can you explain the following:
    In October 2014 NHS PERSONAL HEALTH BUDGETS are available - Are folk with Learning Disabilties like AUTISM able too access a Personal Health Budget as some have continuing health care like prescribed medication and visits too the GP or Physciatrist or Specialist regularly lifelong?
    I look forward too your reply soon ,

    Thanks
    Brian Ward
    72 Brookfield
    Cheadle
    Stockport sk81es
    01614286638

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Last Updated : 21 September 2012. Page Author: Laura Bimpson.