Raising ambitions for personal health budgets

Last week I met with the peoplehub national personal health budgets peer network, a passionate and informed group of service users.

They are committed to sharing their experience in pursuit of increasing the number of people who benefit from greater choice and control over their healthcare and driving further improvements of the model.

Hearing people speak about the transformative impact of personalised support, sometimes involving complex change and sometimes just very simple shifts, it struck me as rather odd that there is still so much debate over the concept of a shift to greater patient empowerment.

Since my first blog back in November when I joined NHS England as the Director for Personalisation and Choice, I’m pleased to have already seen great progress in the move to deliver greater patient empowerment within the NHS. I remain committed to ensuring people are able to benefit from more flexibility and control over their care, and to do that at scale we are developing plans that are bold, challenging and transformative.

Momentum grows for the rollout of personal health budgets as CCGs across the country prepare to expand availability of these to others who could benefit from April this year.

These will be outlined in ‘local offers’ currently being developed by CCGs, which will be agreed by their local Health and Wellbeing boards, enabling increasing numbers of people to access more flexible, person centred care.

Personal health budgets being delivered at scale are essential to the Five Year Forward View, and the Shared Planning Guidance for CCGs outlines an expectation of increasing the numbers of personal health budgets to between 50,000 and 100,000 by 2010/21. This only represents around one-to-two people per 1,000 of the population, but it means we need to get serious about increasing the availability to substantial numbers of people.

Of course, personal health budgets are relatively new and so far only the small number of people eligible for NHS Continuing Healthcare have a right to have one, but we are embarking on a wealth of initiatives to look at how they could work for a much broader range of people including, for example, people with a learning disability, those needing to plan end of life care, wheelchair users, and looked after children.

We have recognised that the personal health budget model provides a transformative tool to support an individual to achieve improved health and wellbeing outcomes.  We are also determined to respond effectively to the demand for increased choice and control in areas where people feel more individually tailored support is required.

It’s encouraging to hear the enthusiasm of commissioners like Joyce who can see the opportunities offered by personal health budgets, and where they can provide solutions to some of the difficulties facing the NHS.

Achieving this ‘personalisation revolution’ is undoubtedly a challenge, but one that I, and the great team at NHS England, is certainly ready for. I’d like to take this opportunity to invite senior CCG colleagues to join me in stepping up to the challenge at our conference on 18 May: Realising the Five Year Forward View: Driving personalisation through personal health budgets, which will bring senior leaders together from across the NHS and the voluntary sector to set out the national approach and way forward for personal health budgets.

I’m delighted that NHS England Chief Executive, Simon Stevens and the Minister for Community and Social Care, Alistair Burt, will be speaking at the conference, demonstrating the commitment to lead the charge towards patient empowerment through personal health budgets.

Personal health budgets need to become a fundamental component of the NHS commissioning system, as through handing more power to individuals and communities CCGs are incentivised to ensure that their provider models are more responsive to the needs of individuals, rather than just providing generic services. This has the ability to significantly drive up standards of care, as well as offering flexibility where people need something different that works in their unique circumstances.

It is obvious that with the increasing number of people living with long term, complex health conditions, we need more than our traditional health services have offered in the past. We have much to learn from the voluntary sector and how our communities can support people to stay well at home, wherever possible, and I welcome collaboration with our third sector colleagues to help us shape the further rollout of personal health budgets.

Health and care system leaders across England are currently working on local Sustainability and Transformation Plans which set out each area’s strategy for delivering on the vision outlined in the Five Year Forward View. Personal health budgets will be integral to delivering on the commitment to reducing the health and wellbeing gap, and the national personal health budget delivery team will be developing a package of support to sit alongside this expansion.

Senior CCG leaders are invited to join us at ‘Realising the Five Year Forward View: Driving personalisation through personal health budgets’. This one day conference will be held on Wednesday 18 May at the Kia Oval in London.

Please book your place now on the NHS England events website or find out more by contacting

I look forward to speaking to some of you on 18 May and hearing your ideas about how our team can help you to realise the personalisation revolution in your area.

James Sanderson

James Sanderson is the Director of Personalised Care at NHS England and Improvement, working within the Strategy and Innovation Directorate to oversee the strategy and delivery for a range of programmes that are helping to empower people to have greater choice and control over their care through the delivery of Universal Personalised Care. This includes the Personal Health Budgets programme, Social Prescribing, Shared Decision Making, Personalised Care and Support Planning, Maternity Pioneers and developing and implementing new models of delivering patient choice.

James joined NHS England in November 2015, and was formerly Chief Executive and Accounting Officer for the Independent Living Fund (ILF). The ILF used to support disabled people across the whole of the UK to live independent lives through the provision of direct payments enabling the purchase of personal assistance support.

After graduating, James embarked on a career in the private sector before joining the ILF in 2002 to undertake a number of senior roles including Operations Director with responsibility for front line service delivery, and Business Development Director with responsibility for performance development, change management and information governance.

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