The importance of personalised care and personal health budgets in addressing health inequalities for people within minority groups

Personalised care delivers improved health and wellbeing outcomes for people of all ages with a range of healthcare needs based on what matters to them as individuals.

Personal health budgets aim to give people greater choice, flexibility and control over the healthcare and support they access, particularly when traditional service delivery does not meet the person’s needs.

The NHS Long Term Plan commits that 200,000 people will benefit from a personal health budget by 2023/24. This is supported further with the government’s Integration White Paper and recent Road to Recovery NHS reform speech, in which Health and Social Care Secretary, Sajid Javid, advocated for the significant expansion of personal health budgets, with personalisation becoming the norm. 

Isaac Samuels, co-chair of the Association of Mental Health Providers Lived Experience Advisory group and recipient of self-directed support, says: “Personalised care enabled me to break the cycle of the revolving door of mental health services. Having a personalised approach to my care enabled me to start my recovery journey and to have better mental health as it met my holistic needs”. 

Sadly, Isaac’s positive experience of personalised care – as a person from a minority community and with a long history of mental illness – contrasts starkly against many people with similar backgrounds and healthcare needs.

The report by the NHS Race and Health Observatory shows unacceptable levels of racial inequalities across the NHS and recommends partnership working with ethnic minority voluntary, community and social enterprise (VCSE) organisations to improve mental health services.

As part of NHS England and NHS Improvement’s Advancing mental health equalities strategy – overseen by the Advancing Mental Health Equalities Taskforce which includes the NHS Race and Health Observatory and other VCSE stakeholders – the Patient and carer race equality framework (PCREF) is one of several initiatives that aims to improve experiences of care for ethnic minorities across all mental health services. PCREF is currently being piloted in four areas in partnership with ethnic minority communities.

Additionally, the Tackling Inequalities in Mental Health through Personalised Care Development Support programme is a partnership between Association of Mental Health Providers and the Race Equality Foundation, sponsored by NHS England and NHS Improvement’s Personalised Care group.

This focuses on a set of tangible actions that local health and care systems can take to help facilitate continuous system-wide improvement, illustrating the transformative potential of personalised care in tackling inequalities in mental health.

The role of the VCSE sector is highlighted as essential in the transformation of mental health and allied services, premised on the principles of co-produced, personalised care, as evident from the Race Equality Foundation’s review on personal health budgets.

The supply and demand challenges facing our local health and care systems (systems which, by definition, must embrace the VCSE sector) are well known. The programme is intended to have a particular focus on identifying the capacity and development support required for VCSE mental health organisations. This is in light of learning from NHS England and NHS Improvement’s Personalised Care programme, the implementation of the Community mental health framework for adults and older adults and the recommendations of the Mental Health and Wellbeing Advisory group to the Department of Health and Social Care COVID-19 Social Care Task Force.

We have been really encouraged by the energy and commitment shown by colleagues in both the NHS and VCSE in two local areas; Blackburn with Darwen, and North East and Cumbria Integrated Care System.

Both have offered to participate in the action learning set activity, that forms a core part of this programme, during 2022. We will be sharing our learning from the programme via partner websites including:

Ultimately, our hope is that the learning from this programme will help inform the development of a replicable model. This will facilitate a culture of continuous system-wide improvement in the delivery of personalised care and personal health budgets for people with mental health needs and their unpaid carers.

It should also guide the development of integrated care systems, for which the principles of personalised care and the drive to address racial inequalities in access to mental health services, support and outcomes must be addressed.

Photograph of Isaac Samuels, co-chair of the Working Group of the APPG on Adult Social Care

Isaac is a member of National Co-production Advisory group, Think Local Act Personal (TLAP).

He is a co-chair of the working group of the All-Party Parliamentary Group on Adult Social Care and is a committed community-minded individual working within the third sector for many years. He works closely with local government and national charities, the Department of Health and Social Care, and TLAP. His primary focus is supporting a systematic approach to improve services for the people who need to access them and ensuring they meet the needs of the population by embedding communities’ voices at every level.

Isaac’s achievements include:
• Considerable influence and success in terms of reducing the barriers that people who have impairments, and other seldom heard groups, face by ensuring that these barriers are explored in an open, honest, reflective way that supports people to retell their narratives in a way that makes them stronger.
• Sharing his own personal narrative and drawing on the narratives of others to support this life mission of ensuring that everyone has the same opportunities regardless of impairment, age and socio-economic backgrounds.
• Supporting a number of important social changes over the years from LGBT+ rights to choice and control and co-production.
• He is currently involved in numerous projects including research, lecturing, charity work, trusteeship, management and steering group leadership roles with a number of organisations.

All of this is achievable for Isaac as he receives support from a personal assistant (PA) through a direct payment, Isaac is passionate about self-directing his own support and the role that PAs play within the social care sector.

Photograph of Nikeeta Sohpaul, registered mental health nurse, working as a manager within the Personalised Care group at NHS England and NHS Improvement

Nikeeta Sohpaul is a registered mental health nurse, working as a manager within the Personalised Care group at NHS England and NHS Improvement. Nikeeta has worked within multi-disciplinary NHS teams and is an advocate for children and young people. She has an interest in neurodiversity, social inequalities, mixed-methods research and co-production.