Personal health budgets in end of life care

NHS England is currently supporting five areas across the country to test the use of personal health budgets in the end of life pathway. This work is looking at ways to give people more choice and control over the care that is provided to them in the last weeks and months of their life.

With a focus on how local assessment processes can be modified to ensure people have personal health budgets provided quickly, people with very limited life expectancy are being supported to benefit from more personalised care packages.

The work to provide personal health budgets in end of life care aligns with and supports the Government’s end of life care commitments, which aim to reduce variation in end of life care. These commitments are:

  • honest discussions between care professionals and dying people
  • dying people making informed choices about their care
  • personalised care plans for all
  • the discussion of personalised care plans with care professionals
  • the involvement of family and carers in dying people’s care
  • a key contact so dying people know who to contact at any time of day.

Areas trialling personal health budgets in end of life

East Lancashire CCG

They have set up their pilot with their integrated neighbourhood team in Ribblesdale with the support of the GP practices. Their first step has been training and awareness raising of the local professionals and care providers and developing a how to guide on personal health budgets.

Warrington CCG

This work is part of a whole system review to redesign local end of life services with a focus on supporting people with neurological conditions, short breaks and respite for children. Their initial work has been working with the local hospice and providing hospice at home services through a personal health budget.

More information about personal health budgets in Warrington can be found on the CCG’s website.

In September 2017, Warrington CCG was shortlisted for an HSJ award for Compassionate Patient Care, recognising their work to commission for choice in end of life care. The results will be announced at an awards ceremony taking place in November 2017.

South Derbyshire CCG

The project in South Derbyshire is aligned to a programme of transformation focused on the development and investment of local community based services that take hospice care to the patients and de-medicalise dying. The work is starting in one locality, Swadlincote, across health, social care and the voluntary sector in association with their local hospice and day unit.

Horsham and Mid Sussex CCG and Crawley CCG

Here the work is forming part of the development of the wider programme of transformation for patients with complex long term conditions. It will test the viability of an enhanced pathway between multidisciplinary teams supporting people with long term conditions and traditional end of life teams. The work seeks to align the team’s processes with end of life planning, to bring forward the conversations and subsequent care choice into the last 12 months of life rather than the last few weeks of life.

Northern, Eastern and Western (NEW) Devon

New Devon CCG are redesigning the pathway for personal health budgets at the end of life, by streamlining local processes, including reviewing current processes used in Continuing Healthcare to ensure they are appropriate for the end of life. They are working with local voluntary and community sector organisations to develop local expertise in support planning.

The Network

In addition there is a growing network of other interested professionals and organisations who are currently working on developing and providing personal health budgets in end of life. These are currently:

  • Birmingham Cross City CCG
  • Islington CCG
  • Oxfordshire
  • The South West Strategic Clinical Network Lead
  • West Suffolk CCG and Ipswich and East Suffolk CCG
  • Camden
  • Swindon
  • Luton Integrated Personal Commissioning
  • Independent Lives West Sussex

To find out more or join the network please contact england.personalhealthbudgets@nhs.net.