Introduction to the framework

Integrated Personal Commissioning (IPC) and personal health budgets are part of a wider drive to personalise health, social care and education.

They promote a shift in power and decision-making, to enable a changed, more effective relationship between the NHS and the people it serves, aligning to the Five Year Forward View.

Integrated Personal Commissioning is a partnership programme between NHS England and the Local Government Association. It supports the improvement, integration and personalisation of services, building on learning from personal budgets in social care and progress with personal health budgets.

This framework provides best practice advice, not statutory guidance. The Integrated Personal Commissioning operating model sets out the essential components of Integrated Personal Commissioning and provides a template for local areas to follow. It provides a best practice approach for implementing personal health budgets.

The model is aimed at Integrated Personal Commissioning areas, but will be of interest more widely. This includes NHS commissioners and others involved in providing health, education and social services, including the independent and voluntary sectors, as well as people interested in personal health budgets or IPC.

Foreword

“At a time when resources are tight, we’re going to have to find new ways of tapping into three incredible sources of ‘renewable energy’. Boosting the critical role that patients play in their own health and care. Supporting the amazing commitment of carers and volunteers and communities to sustaining their health and social care services. And unleashing the passion and drive of the million plus frontline NHS staff who are devoting their professional lives to caring”.

Simon Stevens, Chief Executive, NHS England [1]

The publication of this personalised health and care framework is an important milestone. The framework provides advice and practical guides for the NHS and local government to support progress with Integrated Personal Commissioning and personal health budgets. It updates the personal health budgets toolkit, building on learning from implementation since 2012 and from the Integrated Personal Commissioning programme.

Our shared ambition is that by 2021, many thousands of disabled people and people with long-term conditions – including children and young people – will benefit from truly personalised care, through personal health budgets and a wider rollout of Integrated Personal Commissioning (IPC).

People with long-term health conditions, disabled people, and their families have long been asking for the chance to have choice and control over their support. IPC and personal health budgets put this into practice, enabling people to plan their own care and support, connect to others with similar experiences, and play a full part in the wider community. The approach makes full use of the skills and assets of people with lived experience, their families, front-line staff, local charities, community groups and social enterprises.

This is a move towards the more equal relationship between services, citizens and communities set out in the NHS Five Year Forward View.[2] The IPC and personal health budgets delivery framework will support the work of the new care model vanguards, and Transforming Care partnerships. It can help adult social care and children’s services to make progress with health and social care integration and to meet the new duties set out in the Care Act 2014 and Children and Families Act 2014. Key parts of the framework have been produced together with the Local Government Association (LGA).

“The LGA are co-sponsors of IPC because it brings to life two key policy priorities for health and social care – integration and personalisation. Personal budgets give individuals more choice and control over the services they need to live their lives as they choose. It puts people with long term conditions and disabilities on an equal footing with professionals in planning care and support. It also builds on the experience of adult social care services of using pioneering personal budgets, direct payments and personalised care plans to transform people’s lives”.

Cllr Izzi Secombe, Chairman of the Community Wellbeing Board, Local Government Association

The expansion of personal health budgets and IPC is an important means not only to put people in the driving seat, but also to help the NHS and local government respond to increasing demand with limited resources. The independent evaluation of personal health budgets found them to be cost-effective, improving or maintaining outcomes while maintaining or reducing costs. Local area coordination has been shown to improve outcomes. Results include reduced demand on GPs, and less use of social care services[3]. The Realising the Value programme [4] has demonstrated the benefits of peer support, assetbased approaches and self-management.

“I can confidently say every single person has benefitted from moving to personal health budgets.”

Holly Squires, local NHS Continuing Healthcare manager [5]

Already, over 15,800 people are directly controlling NHS money through a personal health budget, a 108% rise in one year. By 2021 our aim is for at least 100,000 people to have more choice and control through a personal health budget. Through IPC, many more people could benefit from a truly personalised model of care that joins up health, social care and other services around the needs and preferences of each person and their family. Our plan sets out how IPC and personal health budgets can help to reduce health inequalities, through a joined-up, person-centred approach.

“Co-production offers a radical yet practical route to re-organise public services that makes a real change… nothing about me, without me”.

Clenton Farquharson MBE, Think Local Act Personal partnership [6]

Over the last year we have developed the IPC operating model, working together with IPC sites, voluntary, community and social enterprise partners and our strategic co-production group – people with lived experience of personalised approaches to health and social care. The model builds on the IPC emerging framework [7] published in May 2016, and is backed up by a set of practical tools and guides. These materials will enable personalised approaches to reach many more people, and yet stay true to purpose. The co-production group developed the key features of IPC and personal health budgets, setting out what people with lived experience and their families expect to see. IPC and personal health budgets encourage local innovation and learning, but there are no new ‘must-dos’.

For people and their families, this is a chance to be recognised as experts by experience with assets, strengths and ambitions, rather than with needs to be met. For the NHS, this is a chance to support people to manage their own health and care, contributing to the long-term sustainability of the system. For local government, this builds on many years of leading the way with personalisation, and enables better use of resources. For the voluntary sector, this means a greater role in helping people and their families make connections in their local communities.

The publication of this framework shows we are serious about personalisation and clear about how it can be delivered in practice.

  • Clenton Farquharson, Michelle Romdhani, Colin Royle, Isaac Samuels, Mel Smeeton and Keymn Whervin, IPC and personal health budgets strategic coproduction group
  • Alex Fox, Chief Executive Officer, Shared Lives
  • Plus Dame Christine Lenagan, Director, Council for Disabled Children
  • James Sanderson, Director of Personalisation and Choice, NHS England

References

  1. Simon Stevens speech 1 April 2014.
  2. NHS Five Year Forward View, NHS England, October 2015.
    Next steps on the NHS Five Year Forward View, NHS England March 2017
  3. Local Area Coordination network.
  4. Realising the Value programme.
  5. Holly’s story.
  6. What is coproduction?
  7. Integrated Personal Commissioning Emerging Framework.