Evidence and case studies
The evidence base for personalised care continues to grow, demonstrating a positive impact on people, the system and professionals. Shared decision making between people and clinicians about their tests, treatments and support options leads to more realistic expectations, a better match between individuals’ values and treatment choices, and fewer unnecessary interventions.
Personalised care also has a positive impact on health inequalities, taking account of different backgrounds and preferences, with people from lower socioeconomic groups able to benefit the most from personalised care.
The original personal health budget (PHB) independent 2012 evaluation, led by the Personal Social Services Research Unit at the University of Kent, showed improved quality of life and reduced people’s reliance on unplanned care eg A&E admissions, as well as overall savings of £3100 per person per year for CHC PHB holders. This included changes to direct and indirect costs and the majority of people were living in their own home.
Other recent highlights include:
- In a recent independent survey, 86% of people with a personal health budget said that they had achieved what they wanted with their PHB and 77% of people would recommend PHBs to others
- PHBs in NHS Continuing Healthcare (CHC) have also been shown to achieve an average 17% saving on the direct cost of home care packages. Whilst we do not expect this 17% saving to be repeated in a system operating at scale, it creates a compelling case to change the approach to delivering CHC home care.
- From tracking over 9,000 people with long-term conditions across a health and care system, evidence has shown that people who are more confident and able to manage their health conditions (that is, people with higher levels of activation) have 18% fewer GP contacts and 38% fewer emergency admissions than people with the least confidence.
- A literature review of over 1,000 research studies found peer support can help people feel more knowledgeable, confident and happy, and less isolated and alone.
- A recent systematic review of 73 studies of personal budgets in health and social care across the globe found “positive effects on overall satisfaction, with some evidence also of improvements in quality of life and sense of security. There may also be fewer adverse effects. Despite implementation challenges, recipients generally prefer this intervention to traditional supports”.
- A 2019 internal analysis of NHS Continuing Healthcare data showed that care and support accounts for 94% of PHB costs. 89% is direct personal care, activities of daily living and delegated healthcare tasks and support to achieve wellbeing outcomes. A further 5% is for the remaining care and support elements of the personalised care and support plan, such as physiotherapy, respite and other clinically approved initiatives.
Quarterly personal health budget figures
At the end of Quarter 4 (end March 2019) 54,143 personal health budgets have been delivered across the country, meeting the Five Year Forward View: Next Steps commitment to 50,000 personal health budgets by 2020-21 two years early.
- Working with a health and wellbeing support worker helped Victoria to better manage her condition. Now she’s more confident, is making friends and dreaming again
- Personal health budget significantly reduces transport costs by £25K per year and gives more choice and control to siblings in Midlands
- My personal health budget gives me control, makes me the boss, and lifts a weight off George’s shoulders
- Flexible funding allows Dylan to live independently for the first time in his life and save on on-going costs
- A primary care navigator helped John to get his life back and address his ongoing health and social needs
- Social prescribing linked me to art which saved my life
See Universal Personalised Care Case Studies for more case studies.