My ambitions for Personal Health Budgets

As he addressed a Westminster Health Forum today to discuss the next steps for personal health budgets, NHS England’s Head of the Integrated Personal Commissioning programme shares goals for making them key to supporting people living with complex and long term health conditions:

For those of us who are passionate about person centred care these are exciting times.

I began work at NHS England in September last year leading on Integrated Personal Commissioning and personal health budgets, but I have a much longer history with the personalisation agenda in health and social care, so I was delighted to see the renewed commitment to personal health budgets outlined in the recent Mandate to the NHS, and the subsequent Planning Guidance for CCGs.

Undeniably it sets us a challenge – we’re talking about working in a very different way for the NHS.

True personalisation changes the relationships between people and professionals, and it represents new ways of planning and paying for services. These are things that take time to embed.

Traditionally commissioning is about purchasing health services on a population basis, and this usually means a block contract between a CCG and a health provider to provide key services. Looking at how an individual may use their slice of this funding to access something different represents a pretty big shift for the NHS, and that takes time to get right.

It also takes time for people to see how this new approach to managing long term conditions could work from them; there are concerns and questions that need time to talk through, but I really believe it needs to be an option for people who have some of the most complex health needs. Of course equally it isn’t going to be the best option for everyone, and would never replace the traditionally commissioned services that will continue to work well for many people. This is all about ensuring real choice.

Adults eligible for NHS Continuing Healthcare and children who receive continuing care have had a legal right to have a personal health budget since October 2014. The original personal health budget evaluation showed the potential for a whole range of people living with long term health conditions, and the recent Planning Guidance set out an expectation that around 50-100,000 people could benefit by 2020.

In order to expand their local offer of personal health budgets, clinical commissioning groups are currently looking at who else in their local area could benefit from this additional choice and flexibility.

If you, or someone that you care for has a long term or complex health condition and you think that a personal health budget could be an option to better manage care – then speak up, and make your views heard.

Now is the time to be part of local conversations, so why not find out how you can get involved with your CCG to help them shape their local plans. If you’re not sure how to get involved, you can contact your local Healthwatch to find out about engagement mechanisms in your area.

Pete’s experience is a great example of the difference that a more personalised approach can take. Pete lost his arm in a road traffic accident and the prolonged use of a prosthetic limb left him with chronic pain that the mainstream, health services he was referred to just weren’t able to address.

His condition was deteriorating in a way that affected his mental wellbeing as well as his mobility.

His use of services had become driven by crisis, instead of supporting him to find ways to manage his pain. Why would we want to carry on funding services or treatments that were barely keeping him on an even keel? The deep tissue massage that continues to prevent him from seizing up isn’t more expensive than the traditional service he was offered, and there’s plenty of evidence that this is keeping him mobile and enabling him to lead a full, active life.

Personal health budget care plans and the way the money is spent need to be agreed by the patient, their healthcare professional and ultimately the CCG, so there are safeguards in place to ensure public funds are spent wisely to meet health outcomes.

Our personal health budget delivery team has been busy working with CCGs to get them ready to scale up their plans through our ‘Developing a local offer programme’ and it’s been encouraging to see commissioners begin to step up to the challenge of a personalised health service. We’re also working closely with the Transforming Care team to explore how personal health budgets can be an option to enable people with learning disabilities and autism to live in the community.

We’re running a series of events, and there’s still time to book your place if you want to understand more.

There’s still a long way to go, but I know from my experience working with personal budgets in social care that after a slow and steady start while new ways of working are tested out and confidence gained, it’s now time to raise our game so that choice becomes more than just an ambition.

Sam Bennett

Dr Sam Bennett is Head of the Integrated Personal Commissioning programme and the Personal Health Budgets team at NHS England. He is passionate about personalised care and support and has worked on implementing personalised systems in health and social care at local, regional and national levels for over 10 years.