I’ve recently joined NHS England as the Director of Personalisation and Choice, bringing together the teams who have been responsible for Personal Health Budgets (PHBs), Integrated Personal Commissioning (IPC) and Patient Choice.
I was previously the Chief Executive of the Independent Living Fund, which supported disabled people to live independently with choice and control over their lives. This is an agenda which I am passionate about and I’m delighted to be working with people who share the same determination to make our health service ‘person centred’ with real choice being offered to patients.
It’s been a busy first few weeks in post. I’ve had the pleasure of attending one of our ‘developing a local offer for personal health budgets’ events. The Personal Health Budget Delivery Team are working hard to support CCGs as they make their business cases to extend the availability of personal health budgets to others who could benefit, in ways that are sustainable and affordable. It was great to meet with staff from CCGs, their support services and healthcare providers to hear the opportunities and challenges that personalisation presents.
More importantly I’ve met with some of the peoplehub peer leaders and heard them share their real, personal experiences of managing personal health budgets which always puts our ‘big ideas’ into perspective.
It’s easy to envisage high level concepts, but these concepts are meaningless unless what we’re doing enables people to make meaningful choices that give them more control and flexibility in the way they manage their long term health needs and live their lives.
If you haven’t had an opportunity to speak with people who have made personal health budgets work for them, I would really encourage you to hear them tell their stories.
I have also been engaged in work to improve the choices that women are provided with in maternity services, and discussions to improve the approach to end of life care. It is clear that we have much work to do but the passion I have seen demonstrated for making a real difference to the current approach provides an excellent energy to drive forward what is needed.
At the Health Service Journal annual lecture on 29 October, Jeremy Hunt talked about an “Irresistible, inescapable shift to patient power”. It is clear that opinion is converging in support of a health service built on the principles of patient choice and control. However, there is still a long way to go to achieve a position where personalised approaches are the default setting.
What’s also clear is that one agency or organisation isn’t going to achieve this alone. Delivering a universal culture of personalisation and choice in the NHS will only be achieved if we work together across commissioning organisations, provider trusts, the voluntary and community sector and with people themselves. We need strength in numbers to lead the charge towards patient empowerment. One of the cornerstones of the IPC Programme is the need for CCGs and local authorities to work co-productively with people and communities. The challenges ahead aren’t ones that statutory services can fix alone.
This week Together for Short Lives published an excellent guide for young people with life limiting conditions and their families to help them navigate across health, social care and education systems in order to access personal budgets. This is exactly the kind of collaborative working we need to not only embed person centred practices in the NHS, but to be engaging directly with people to enable them to get the best from health services, in ways which are efficient, effective and work for them. For seriously ill young people getting this right, so that they can live a full life, simply can’t be more important.
When personal health budgets are delivered well the impact can be overwhelmingly positive for people. It’s also clear that by empowering individuals to take control of their support, the wider system benefits through reduced use of emergency services, unplanned hospital admissions and overall cost savings.
Personal health budgets are still relatively new and represent a real shift in culture for the NHS, so it’s not altogether surprising that support for them is not universal. We have seen recent articles that attempt to trivialise the complex, considered work that professionals in the field undertake in order to deliver positive outcomes for individuals.
We need, therefore, to continue to champion the need for wider personalisation and choice, to articulate what patient empowerment means and how it can be delivered, and work hard to listen to concerns and change opinion where needed.
While I’m sure there will be interesting conversations ahead, I’m also determined that we move past talking to see real change happen so that we deliver on the commitments of the Five Year Forward View and ensure that people are enabled to take greater control over their own health.