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Agenda Item 4a

Sefton Public Engagement and Consultation Panel Date: 11th February 2016 Title: Proposal to undertake Public Engagement and Consultation Activity –

NHS South Sefton and NHS Southport and Formby CCG Personal Health Budget Engagement

Report of: Tracey Forshaw – Programme Manager Vulnerable People – NHS

South Sefton and NHS Southport and Formby CCG Clare Johnston - Carers Voice Development Officer - Sefton Carers Centre

1. Purpose of the Report 1.1 To receive information with regard to the consultation plans being

developed with regard to the Personal Health Budgets for NHS funded care

2. Background 2.1 The main purpose of the Public Engagement and Consultation Panel is

to coordinate and ensure the quality of public engagement and consultation, in accordance with the standards for engagement and consultation.

3. Personal Health Budgets for NHS funded care 3.1 Following a successful pilot programme by the Department of Health,

which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB.

The Government has confirmed a commitment in the NHS mandate

2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015.

What is a Personal Health Budget (PHB)? PHBs are the allocation of NHS funding which patients, after an

assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people to exercise choice and control over their lives is central to achieving better outcomes for individuals.

For Eligible Persons there is a duty on CCGs to:

• Consider any request for a PHB; of 14

• Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs.

There are five essential characteristics of a PHB. The person with the

PHB (or their representative) must:

1. be able to choose the health outcomes they want to achieve 2. know how much money they have for their healthcare and support 3. be enabled to create their own care plan, with support if they want

it 4. be able to choose how their budget is held and managed 5. be able to spend the money in ways and at times that make sense

to them, as agreed in their plan. 3.2 There is a requirement to engage to raise awareness of individuals right

to a personal health budget (PHB), to ensure that there is an understanding of what the offer will mean and to manage expectations in relation to the delivery of PHB’s across the borough of Sefton. To consult and enable feedback on the proposed literature which has been developed to promote and explain PHB’s, which are intended to be available on the CCG’s website from April 2016.

3.3 It is likely that this will have an impact on 3rd sector organisations, social

care colleagues, health practitioners, advocacy services ability to signpost appropriately following request.

4. The Consultation 4.1 The consultation and engagement process will be carried out by Sefton

Carers Centre on behalf of NHS South Sefton and NHS Southport and Formby CCG, following Sefton Carers Centre successful national bid to secure funding to promote PHB’s across the borough of Sefton. The consultation will take place in two phases.

4.2 Phase One Engagement 1st February 2016 – 29th February 2016 Timescale for engagement: The engagement will cover a 4 week

period. Representation of the groups below will be sought from pre-existing groups that meet to support these health conditions.

Method of engagement: Focus groups with a maximum of 10 people

per group Patient representation groups to include:

• Parents of children eligible for Continuing Health Care (CHC). If a child receives CHC, they will have an education, health and care plan (an EHC) plan, or will be transferring to one very soon.

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• Adults eligible for CHC, including individuals with Long term health conditions, Learning disabilities and Mental health conditions.

• Service users in receipt of PHB’s. The engagement process will include residents from both the North and

South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process

Areas to receive feedback on: Individuals will be shown copies of

literature that has been compiled to promote and explain what Personal Health Budgets are. The engagement will seek to address and clarify the understanding of the points below;

• Is there an understanding of what the offer of a PHB means?

Specifically, seeking understanding on what the distinction between the ‘right to ask’ and ‘right to have’ change means in practice, gather expectations of this.

• Assess how well people feel their needs are understood and how well their needs are currently met

• Assess if any individual has been turned down for PHB in the past, what did they ask for and was it explained clearly and understood the reasons for PHB being turned down

• What would be the likeliest use for PHB funding should it be received

• What is felt to be the biggest barrier to accessing the funding • General concerns/reservations from actual or potential PHB budget

holders • Testing of literature for proposed leaflets including a standard leaflet

and an easy read version in addition to proposed website text to receive feedback on if the level of information is sufficient or there are any changes required to be made to address any areas not currently covered/explained sufficiently

The above are the key themes/questions which will be used to shape the

discussions. How the engagement may help to shape future work plans:

• Look to revise proposed literature dependent on feedback from the engagement process if changes are requested to be made

• Managing expectation, working with service users, local residents, NHS workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton.

4.3 Phase 2 engagement process post 1st April 2016 to focus on NHS

professionals across the wider NHS, partner organisations and service users.

Timescale for engagement: The engagement will cover a 4 week

period from 1st April – 30th April 2016 Due to timescales involved, representation of the groups below will be sought from pre-existing groups that meet to support these health conditions.

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Method of engagement: Focus groups with a maximum of 10 people per group and 1:1 interviews with NHS professional to be flexible with work commitments

NHS Professional representation: To engage with a range of NHS

professionals across the wider NHS workforce Patient representation groups to include:



• Service users in receipt of PHB’s. Partner organisation engagement: to engage with partner

organisations across the voluntary, community and faith sector to ensure that the local offer of PHB’s is understood and organisations can promote PHB’s locally as an option to service users.

The engagement process will include residents from both the North and

South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process.

How the engagement may help to shape future work plans:



5. Recommendations 5.1 The Public Engagement and Consultation Panel is recommended to: a) Appraise the public engagement and consultation plan for Personal

Health Budgets in Sefton b) Request that the officers return to the Panel to provide details of

their feedback and evaluation resulting from the above consultation.

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Public Engagement & Consultation Panel

PROJECT PROPOSAL

Project Title: NHS South Sefton and NHS Southport and Formby CCG Personal Health Budget Engagement

Is your project linked to:

A new service - please attach a new Equalitiess Impact Assessment

Lead officer: Tracey Forshaw Contact no

0151 247 7247

Designation Programme Manager Vulnerable People

E-mail [email protected]

Which of the Council’s Priorities does your Consultation relate to (please tick)

x The Economy

x The Most Vulnerable

x Health and Wellbeing

Reshaping the Council

Resilient Communities

The Environment

Which of the Health and Wellbeing Board’s Priorities does your Consultation relate to (please tick)

Ensure all children have a positive start in life

Support people early to prevent and treat avoidable illnesses and reduce inequalities in health

x Support older people and those with long term conditions and disabilities to remain independent and in their own homes

x Promote positive mental health and wellbeing

Seek to address the wider social, environmental and economic issues that contribute to poor health and wellbeing

Build capacity and resilience to empower and strengthen communities

Does this consultation relate to an item on the Forward Plan? If so which one?

N/A

Other partners involved (please state if internal or external to the Council)

Sefton Carers Centre -External

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(Planned) start date

(Planned) end date:

What is the allocated budget?

01/02/16 30/04/16 £10,000

Background/Rationale Following a successful pilot programme by the Department of Health, which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB. The Government has confirmed a commitment in the NHS mandate 2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015. What is a Personal Health Budget (PHB)? PHBs are the allocation of NHS funding which patients, after an assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people to exercise choice and control over their lives is central to achieving better outcomes for individuals. For Eligible 1Persons there is a duty on CCGs to: • Consider any request for a PHB; • Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs. There are five essential characteristics of a PHB. The person with the PHB (or their representative) must: 1. be able to choose the health outcomes they want to achieve 2. know how much money they have for their healthcare and support 3. be enabled to create their own care plan, with support if they want it 4. be able to choose how their budget is held and managed 5. be able to spend the money in ways and at times that make sense to them, as

agreed in their plan.

Aims & Objectives

1 An eligible person is someone in receipt of NHS Continuing Health Care of 14

The purpose of this engagement proposal is to provide a brief overview on how we intend to engage with local residents, establishing their expectations and understanding of Personal Health Budgets to influence local delivery.

Target Audience

Sefton borough wide target audience to include: • Parents of children eligible for NHS Continuing Care (CC). If a child receives

CC, they will have an education, health and care plan (an EHC) plan, or will be transferring to one very soon.

• Adults eligible for NHS Continuing HealthCare (CHC), including individuals with Long term health conditions, Learning disabilities and Mental health conditions.

• Service users in receipt of PHB’s.

Methodology

The consultation and engagement will be undertaken by Sefton Carers Centre, on behalf of and in conjunction with NHS South Sefton and NHS Southport and Formby CCG. There are 2 planned phases. Phase 1 which will commence 1st February to the 29th February which will aim to raise awareness of PHB’s, test and inform proposed literature and to provide clarity in relation to expectation of availability. Focus groups with a maximum of 10 people per group and 1:1 service user face to face/telephone interviews as appropriate. Phase 2 will commence from 1st April to the 30th April, and will look to revise proposed literature dependent on feedback from the engagement process if changes are requested to be made and manage expectation, working with service users, local residents, NHS workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton. Focus groups with a maximum of 10 people per group and 1:1 face to face/telephone interviews with professionals to be flexible with work commitments.

Communications Plan

Key Message Audience Method

Awareness and understanding of Personal Health Budgets locally in Sefton

All as listed above in Phase 1 & 2 methodology

As listed above in methodology

Views and experience of current service users requested to help to inform and potentially influence local delivery of PHB

As above listed under Phase 1 methodology

As above

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Potential barriers to involvement and action to overcome barriers An initial pre consultation and engagement EIA has been completed and its findings will be used to inform the approach used to reduce any potential barriers or inequity with involvement opportunities.

How will you protect the confidentiality of participants?

All activity as listed will be conducted in line and adhering to protections set out in the Data Protection Act, 1998. All information collected is anonymised and information will be stored securely.

How and when do you intend to report or publish the findings?

Phase 1 will be detailed in a report that will be available from 1st March 2016 and can be reported back to this panel, EPEG and through South Sefton & Southport and Formby CCG’s communications. Phase 2 will be detailed in a report that will be available from 1st April 2016 and can be reported back to this Panel, EPEG and through South Sefton & Southport & Formby CCG communications.

Level and type of patient/public engagement (place a tick in all that apply)

Tick Level Description

√ Informing Giving people information about something (a limited opportunity for them to be involved)

√ Consulting Getting people’s views to help you develop/change your services/plans

Deciding together Making decisions using patients’ and public’s views

Acting together

Local people will be involved in making decisions and reviewing your plans/services

Supporting local initiatives

Local people will have the opportunity to lead, develop and deliver activities independently

Does your project include:

Yes/No If No please explain

Questionnaire (Please attach .

Yes Questions used in focus groups/face to face/telephone interviews attached

Other materials (i.e. promotional materials)

Yes Draft patient leaflets

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A stakeholder map (a tool to help you identify your target audience – included in toolkit)

No

Reference to existing data or information that has already been completed (i.e. recent consultation/ research where results can be used to inform your consultation)

No

Any other information you would like to provide?

Attached EIA

If you require further information please contact either Jayne Vincent on 0151 934 3840 or June McGill on 0151 934 4080

Signature of Project Lead: Date: 4th February 2016 Manager Approval: Date: Date approved by Business Intelligence & Performance Team Date Please return this form electronically to:- [email protected] or [email protected]

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mailto:[email protected]


Annex 1 NHS South Sefton CCG and NHS Southport and Formby CCG Personal Health Budget Policy Engagement Proposal

History Following a successful pilot programme by the Department of Health, which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB. The Government has confirmed a commitment in the NHS mandate 2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015. What is a Personal Health Budget (PHB)? PHBs are the allocation of NHS funding which patients, after an assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people to exercise choice and control over their lives is central to achieving better outcomes for individuals. For Eligible 2Persons there is a duty on CCGs to: • Consider any request for a PHB; • Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs. There are five essential characteristics of a PHB. The person with the PHB (or their representative) must: 1. be able to choose the health outcomes they want to achieve 2. know how much money they have for their healthcare and support 3. be enabled to create their own care plan, with support if they want it 4. be able to choose how their budget is held and managed 5. be able to spend the money in ways and at times that make sense to them,

as agreed in their plan.

2 An eligible person is someone in receipt of NHS Continuing Health Care of 14

Phase One Engagement (To be completed by the end of February 2016 by Sefton Carers Centre in conjunction with South Sefton CCG & Southport & Formby CCG) Timescale for engagement: The engagement will cover a 4 week period from 1st February – 29th February 2016 Due to timescales involved, representation of the groups below will be sought from pre-existing groups that meet to support these health conditions. Method of engagement: Focus groups with a maximum of 10 people per group Patient representation groups to include:



• Service users in receipt of PHB’s. The engagement process will include residents from both the North and South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process as indicated in Appendix A. Areas to receive feedback on: Individuals will be shown copies of literature that has been compiled to promote and explain what Personal Health Budgets are. The engagement will seek to address and clarify the understanding of the points below;

• Is there an understanding of what the offer of a PHB means? Specifically, seeking understanding on what the distinction between the ‘right to ask’ and ‘right to have’ change means in practice, gather expectations of this.

• Assess how well people feel their needs are understood and how well their needs are currently met

• Assess if any individual has been turned down for PHB in the past, what did they ask for and was it explained clearly and understood the reasons for PHB being turned down

• What would be the likeliest use for PHB funding should it be received • What is felt to be the biggest barrier to accessing the funding • General concerns/reservations from actual or potential PHB budget holders • Testing of literature for proposed leaflets including a standard leaflet and an

easy read version in addition to proposed website text to receive feedback on if the level of information is sufficient or there are any changes required to be made to address any areas not currently covered/explained sufficiently The above are the key themes/questions which will be used to shape the discussions.

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How the engagement may help to shape future work plans: • Look to revise proposed literature dependent on feedback from the

engagement process if changes are requested to be made • Managing expectation, working with service users, local residents, NHS

workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton.

Phase 2 engagement process post 1st April 2016 to focus on NHS professionals across the wider NHS, partner organisations and service users. Timescale for engagement: The engagement will cover a 4 week period from 1st April – 30th April 2016 Due to timescales involved, representation of the groups below will be sought from pre-existing groups that meet to support these health conditions. Method of engagement: Focus groups with a maximum of 10 people per group and 1:1 interviews with NHS professional to be flexible with work commitments NHS Professional representation: To engage with a range of NHS professionals across the wider NHS workforce Patient representation groups to include:



• Service users in receipt of PHB’s. Partner organisation engagement: To engage with partner organisations across the voluntary, community and faith sector to ensure that the local offer of PHB’s is understood and organisations can promote PHB’s locally as an option to service users. The engagement process will include residents from both the North and South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process as indicated in Appendix A. How the engagement may help to shape future work plans:



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Appendix A – Equality Monitoring Data About you And now a few questions about you. NHS South Sefton Clinical Commissioning Group/NHS Southport and Formby Clinical Commissioning Group wants to provide local people with high quality health services. We can only do this if we understand who our patients are and what our local population needs. You can help us by completing the following questions. The information you provide is confidential and will be used for monitoring purposes only.

Are you a disabled person? Yes No

If yes, please tell us what your disability is related to:

Learning Mobility Vision Mental health Deaf/ hearingimpairment A hidden impairment Other

Please tell us your postcode (the first three characters):

What is your age?

16 or under 17 - 25 26 - 35 36 - 45 46 - 55 56 – 65 66 - 75 Over 75 Prefer not to say

What is your ethnic group/background? White British White Irish East European Gypsy/Roma/Traveller White Other Mixed White/Black African Mixed White/Black Caribbean Mixed White/Asian

Mixed Other Asian/ Asian British – Indian

Asian or Asian British – Pakistani Asian/Asian British – Bangladeshi

Asian or Asian British – Other Black/Black British – Caribbean

Black/Black British – African Black/ Black British – Other

Chinese Any other ethnic group Prefer not to say

Do you have a religion or belief?

No religion/belief Christian (C of E, Catholic, Protestant and all denominations)

Hindu Jewish Muslim Sikh Other Prefer not to say

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Thank you for completing this survey. Your feedback is very much appreciated.

What is your sexual orientation?

Heterosexual / straight (attracted to the opposite sex) Gay/Lesbian (attracted to the same sex) Bisexual (attracted to both sexes) Prefer not to say

Is your current gender identity the same as on your birth certificate?

Yes No Not sure what

the question means?

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Personal Health Budgets

What do they mean?

In Sefton

Produced by Midlands and Lancashire Commissioning Support Unit for NHS South Sefton CCG & Southport & Formby CCG Copyright © 2015 Midlands and Lancashire Commissioning Support Unit. All rights reserved V0_1 October 2015

Introduction The aim of Personal Health Budgets (PHBs) is that patients are given a set amount of money and can decide what care is best for them, in partnership with their NHS team. PHBs are aimed at giving you more choice and control over how money is spent on meeting your health care and wellbeing needs. Together with your NHS team you will develop a care and support plan. The plan sets out your personal health and wellbeing needs, the health outcomes you want to achieve, the amount of money in the budget and how you are going to spend it. Who can have a PHB? From 1 October 2014, adults who are eligible for fully funded NHS Continuing Healthcare funding, and children eligible for NHS continuing care, have a right to have a PHB. Your Continuing Healthcare funding and care package will remain in place if you choose not to have a PHB. It is completely voluntary.

What is a PHB? A PHB is an amount of money, paid to you by the NHS to meet your healthcare and wellbeing needs; planned and agreed between the person or their representative and the local NHS team. You will be able to use your budget for a range of things to help you meet your goals, including personal care and equipment. What does this mean for me? People who are eligible for NHS Continuing Healthcare and Continuing Care for children will have much more say over how their health and wellbeing needs are met. If you are receiving direct payments through social services, you may be able to transfer to a PHB with minimal or no disruption to your current arrangements if you become eligible for NHS Continuing Healthcare. Who is delivering PHBs for patients in Merseyside? The NHS North West Commissioning Support Unit (NWCSU) Continuing Healthcare Team are delivering PHBs with South Sefton CCG and Southport & Formby CCG. It is the CCGs, which are local NHS groups, which buy healthcare services on people’s behalf who are delivering PHBs with organisations providing support. Currently these organisations include Salvere, Your Life Your Way and SOLO Support Services. It is envisaged that over time a wider range of organisations, and therefore choice, will become available. These arrangements will be reviewed on an ongoing basis. How does it work? There are three key steps to meeting health and wellbeing needs under the PHBs system: Step 1 – assessment of needs Your care coordinator will ask you questions to find out what you need for your health and wellbeing. Step 2 – budget allocation

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Your assessment of needs is used to calculate an ‘indicative budget’. An ‘indicative budget’ is an estimate of the money needed to meet your health and wellbeing needs. Step 3 – support planning and using the budget Your care coordinator will then work with you, and those who support you, to decide how best to use the PHB to meet your needs. This will include your choice of how care is delivered. This is written in a support plan, which both you and your care coordinator must sign. While it can take some time to set up your health budget, we will make sure that this doesn’t cause a delay in being discharged from hospital and an interim care package may be offered. Will it affect my benefits? A PHB is not a welfare benefit and is not a part of the benefits system. This means that a PHB is not taken into account when calculating your benefits entitlement. PHBs are given in order to meet health and wellbeing needs, and cannot be spent for any other reason. The Merseyside NHS CCGs have a duty to ensure that payments are being used for what has been agreed with your care coordinator and documented in your support plan. The NHS CCGs are entitled to recover any money that is not spent appropriately. Whatever form of PHB is used, the assessment and review process for Continuing Healthcare remains as it is now. From where does the money come? The funding comes from the same pot of money which pays for either fully funded NHS Continuing Healthcare or Continuing Care for children. How will PHBs work for me? The budgets could work in three ways: 1. Direct payments – This is where either you or one of the agreed support service suppliers

holds the funds to buy the care and support you and your local NHS team decide you need. For audit purposes you or your support service supplier will have to show on what the money has been spent. You will be the employer and will buy and manage the service yourself, supported by the support service supplier as your human resources advisor.

2. A notional budget – With a notional budget no money changes hands. You find out how

much money is available and then talk to your local NHS team about the different ways to spend that money on meeting your needs. They will then arrange the agreed care and support.

3. A budget held by a third party – This is where a non NHS organisation holds the money for

you and helps you decide what you need. After you have agreed this with your local NHS team, the organisation buys the care and support you have chosen, and they become the employer.

For people who lack capacity The agreed representative is responsible for managing the direct healthcare payment, and buying and managing the service. The representative is responsible for the money and, for audit purposes, has to show on what the money has been spent. The representative must involve the individual and act in their best interests.

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Must I have a PHB? People do not have to change the healthcare and support that is working well for them, but if there’s something that isn’t working, that can be changed. On what can my budget be spent?

The aim of PHBs is to allow you real flexibility in planning the care that you need. PHBs are intended to be used for a range of services to help meet people’s goals, such as personal care and, in some cases, selected equipment. People will not pay for emergency care or normal care from a family doctor from their PHB budget.

On what can’t I spend my PHB? People are not allowed to spend the money on: • gambling • debt repayment • alcohol • tobacco • anything unlawful The PHB can’t be used to part-fund treatments alongside patients’ own money. If a patient for any reason wanted to purchase additional care, privately, this would need to take place separately. However, a patient could use their budget to purchase private services that meet their personal health outcomes e.g. a private physiotherapist. Can I employ a relative? Ordinarily, no. The CCG / NWCSU will need to confirm that it is necessary to employ a relative / partner or anyone living in the same household as you, in order to satisfactorily meet your care needs for that service; or to promote the welfare of a child for whom direct healthcare payments are being made. If family members, close relatives and / or people living in the same household as you are to be employed, using a direct healthcare payment, the CCG / NWCSU must agree and record this in the care plan. Will I be asked to show how I have spent the money? Yes, patients are required to keep basic records. Your PHB bank account will be audited. PHBs can only be used as agreed in your PHB care plan. The records will be subject to audit arrangements by NWCSU Finance Department. The balance of the bank account will be reviewed regularly and any money that has not been allocated to your care or support, excluding the contingency funds, will be returned to your CCG (unless a prior agreement has been made with the care coordinator).

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More information Depending on personal preference, there are two organisations working with your local NHS who support people with PHBs. Salvere will help you to employ your own team of staff or SOLO will employ your team of staff. Contact them or see their websites for more information. Salvere: Visit www.salvere.co.uk

By Telephone: 01772 535683 By email: [email protected] By post: Salvere

Suite 6 Leyland House Lancashire Business Park Centurion Way Leyland PR26 6TY

SOLO Support Services Ltd: Visit www.solosupportservices.co.uk By Telephone 0115 815 7010 needs formatting By Textphone: 0115 815 7010 By email: [email protected] By post: SOLO Support Services Ltd

34 Millicent Road West Bridgford Nottingham NG2 7PZ

Your Life Your Way: Visit www.ylyw.org By Telephone 0845 387 1107needs formatting By email: [email protected] By post: YLYW

8 Brunel Court, Rudheath Way Gadbrook Park, Cheshire CW9 7LP

If you want to share experiences, advice and support with other people who have a PHB, their carers and families, you can visit the peoplehub website: www.peoplehub.org.uk. NHS Choices helps people find reliable information about treatments, conditions and healthy living, and to comment on their own hospital experience at www.nhs.uk Find out more about PHBs on NHS Choices at www.nhs.uk/personalhealthbudgets To find out all about choice go to: www.nhs.uk/choiceinthenhs/yourchoices/allaboutchoice/pages/allaboutchoice.aspx For more information about the right to choose where you get treatment, ask your GP, CCG or visit: www.nhs.uk/choiceintheNHS/Yourchoices/Pages/Yourchoices.aspx

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http://www.salvere.co.uk/


http://www.solosupportservices.co.uk/

http://www.ylyw.org/

http://www.peoplehub.org.uk/

http://www.nhs.uk/

http://www.nhs.uk/personalhealthbudgets

http://www.nhs.uk/choiceinthenhs/yourchoices/allaboutchoice/pages/allaboutchoice.aspx

http://www.nhs.uk/choiceintheNHS/Yourchoices/Pages/Yourchoices.aspx

Your health, your way (also called the patients’ prospectus) supports people to take a more active role in decisions about their care, control their condition better, and have a better quality of life visit: www.nhs.uk/Planners/Yourhealth/Pages/Yourhealth.aspx Information Prescriptions are a quick and easy way to provide information about your condition and local services at: www.nhs.uk/ipg/Pages/IPStart.aspx NHS complaints information - If you unhappy with your NHS services Contact: North West CSU Customer Care Team TBC TBC TBC TBC Telephone: TBC Email: TBC

CCG Contact Details TBC

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http://www.nhs.uk/Planners/Yourhealth/Pages/Yourhealth.aspx

http://www.nhs.uk/ipg/Pages/IPStart.aspx

Personal Health Budget (PHB) Engagement

Phase one – Focus group / telephone/face to face interviews

Areas to receive feedback on:

Individuals will be shown copies of literature that has been compiled to promote and explain what Personal Health Budgets are. The engagement will seek to address and clarify the understanding of the points below;

• Is there an understanding of what the offer of a PHB means? Specifically, seeking understanding on what the distinction between the ‘right to ask’ and ‘right to have’ and what this change means in practice, gathering individual’s expectations of this.

• How well do people feel their needs are understood and how well their needs are currently met

• Has any individual has been turned down for PHB in the past, what did they ask for and was it explained clearly and understood the reasons for PHB being turned down

• What would be the likeliest use for PHB funding should it be received

• What is felt to be the biggest barrier to accessing the funding

• General concerns/reservations from actual or potential PHB budget holders

• Testing of literature for proposed leaflets including a standard leaflet and an easy read version in addition to proposed website text to receive feedback on if the level of information is sufficient or there are any changes required to be made to address any areas not currently covered/explained sufficiently

The above are the key themes/questions which will be used to shape the discussions.

All about personal health budgets

Getting the healthcare you need

Easy Read

About this leaflet

The National Health Service (NHS)

has written this leaflet.

This leaflet talks about personal

health budgets and tells you:

• What a personal health budget is

• Why we think they could help

people

• how some people use their

personal health budget

• how to find out more

All about personal health budgets Getting the healthcare you need 1

2

3

5

8

11

14

16

What is in this leaflet

About personal health

budgets

How personal health

budgets work

What you can use a

personal health budget for

Important things about

personal health budgets

How some people use their


Questions about personal

health budgets

How to find out more 19

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About personal health budgets

The NHS has a lot of ways to make

it easier for you to get the best

healthcare for you. A personal

health budget is one of these.

A personal health budget is money

to pay for your healthcare. At the

centre is your care plan, which helps

you decide your health goals

together with your local NHS team.

This means:

• you agree the best way to spend

the money with your local NHS

team. This could be your nurse,

doctor or care manager.

4

• you know how much money

there is for your healthcare

• you have more say about your

healthcare

Some people already get a personal

budget to pay for support from

social services.

Now personal health budgets work

in a similar way.

5

How personal health budgets work

You must spend the money on

things in your care plan that keep

you healthy and safe.

The local NHS has to agree that

these things support your health.

If things are working well at the

moment, you do not have to

change them.

But a personal health budget

means you can change things if

you want to.

6

Personal health budgets can work

in 3 different ways, or a mixture

of them:

1. Notional budget

We tell you how much money there

is for your care

You say how you want us to spend

the money. If your local NHS team

agrees this meets your needs they

arrange the care and support for you.

2. Real budget held by a third party

An organisation, like a charity, looks

after the money for you and helps

you spend it. They are called the

third party.

If the local NHS agrees with how you

want to spend your money, the

organisation buys the care and

support for you.

7

3. Direct payment for healthcare

We give you the money to buy and

manage your own healthcare and

support.

Your local NHS team must agree

that this meets your needs.

You have to tell us what you spend

the money on.

What you can use a personal

health budget for

As long as you agree your care plan

with your local NHS team, you can

use the budget for most types of

healthcare and support.

You can use the budget for things

like:

personal care

doing things that help

you keep well

8 All about personal health budgets Getting the healthcare you need

9

equipment to help meet

your health needs.

You cannot use a personal health

budget to pay for:

emergency health

services

services you normally

get from your family

doctor

things that are not legal

10

paying back money that

you owe other people

gambling

alcohol and tobacco.

Your NHS team will have rules about

what should be in your plan. They

should tell you these before you

write it.

11

Important things about

personal health budgets

• this is still the NHS. So no one

will have to use their own

money to get the NHS care

they need

• services you get using your

personal health budget should

work well and be safe

• using the services should be a

good experience

• personal health budgets should

help all people get the best

services from the NHS. They

should not make things worse

for anyone

12

• you do not have to use a

personal health budget if you

do not want to

• you should have as much

control over decisions as you

want

• organisations that provide your

healthcare and social care

should work with you and with

each other to give you the best

possible service

• if you are not able to have a

personal health budget, you can

still ask your local NHS team

about different ways they could

support your needs in a way that

suits you.

personal health budgets are

starting up slowly to help people

with disabilities or illness which

last for a long time.

13

We tried out personal health

budgets with a small number of

people in some parts of England

We found out that people’s lives got

better and people went to hospital

less often.

Personal health budgets seemed to

help people more if they needed a

lot of help with their health.

Because of this the Government said

that everyone who gets a type of

support called NHS Continuing

Healthcare will be able to ask for a

personal health budget, including a

direct payment. NHS Continuing

Healthcare is for people who need a

lot of help because of their health,

and their health changes a lot.

After that, we hope anyone who

could get better care with a personal

health budget will be able to ask for

one.

14

How some people use their


David

David uses a wheelchair and has a

personal assistant to help with

things he cannot do for himself.

His legs were very sore and a nurse

had to come and put new bandages

on them every day. David was often

late for work because he had to

wait for the nurse.

David used some of his personal

health budget to get his personal

assistants trained to change his

bandages any time he needs them to.

This means David has more

freedom and can go to work when

he needs to.

15

Anita

Anita has a disease that means she

needs someone to care for her 24

hours a day.

She is fed through a tube 6 times a

day and her husband gave up work

to care for her.

Anita uses her personal health

budget to pay for a team of

personal assistants to look after her

at home.

This means she is always cared for

by people who know her and

understand her needs.

16

Questions about personal health

budgets

Who can have a personal health

budget?

People who get a kind of health

service called ‘NHS Continuing

Healthcare’ can ask for a personal

health budget. NHS Continuing

Healthcare is just for people who

need a lot of help because of their

health. Their health changes a lot.

Local NHS groups will be able to

offer a personal health budget to

anyone they think it would help.

Who decides who can have a

budget, how big is it, and what

can you spend it on?

Your local NHS will work out how to

make these decisions in your area.

17

You should always be told how

much money you will have before

you start planning the things you

could spend it on.

Can I have a personal health

budget as well as a personal

budget from social services?

Yes. You can ask them to put this

together into 1 budget so you can

plan for all your needs.

Will I have to manage my own

care?

You will not have to do everything

on your own.

You and your family or carers will

agree a care plan with the NHS.

18

This will say how you will spend

your budget to keep you healthy

and safe.

What happens if something goes

wrong or my needs change?

If your health changes or your plan

is not right for you, you can look at

it with your local NHS team and

change things.

You will always get NHS care in an

emergency.

You can go back to having NHS

care like you did before if a personal

health budget does not work for you.

Will I have to pay towards my

healthcare if I can afford it?

No. There should be enough money

in your personal health budget to

pay for the care you need.

19

How to find out more

Talk to the person who helps most

with your care and support.

This might be your care manager or

a nurse.

They can talk about personal health

budgets with you.

If you have more questions or

would like more information

please:

• talk to your local NHS team

• look at the following websites:

NHS Choices

This website helps people get

good information about illness

and treatment and you can talk

about your own experiences:

www.nhs.uk

www.nhs.uk/personalhealthbudgets

http://www.nhs.uk/

http://www.nhs.uk/personalhealthbudgets

20

NHS Continuing Healthcare

You can find out more about NHS

Continuing Healthcare here:

www.nhs.uk/chq/pages/2392.aspx

Information prescriptions

This is a quick and easy way to provide

information about different health

problems and local services:

www.nhs.uk/ipg/Pages/IPStart.aspx

Peoplehub

The peoplehub website is a good

place to talk with other people who

have a personal health budget and

their families:

www.peoplehub.org.uk

http://www.nhs.uk/chq/pages/2392.aspx

http://www.nhs.uk/ipg/Pages/IPStart.aspx

http://www.peoplehub.org.uk/

NHS complaints information

If you are unhappy with your NHS service contact:

Midlands & Lancashire CSU

Customer Care Team

Jubilee House, Lancashire Business Park, Leyland PR26 6TR

Telephone: 01772 214200

Email: [email protected]

CCG Contact Details

Blackburn with Darwen CCG

Telephone: 01254 282000


Chorley and South Ribble CCG

Telephone: 01772 214 200


East Lancashire CCG

Telephone: 01282 644700


Fylde and Wyre CCG

Telephone: 01253 306305


Greater Preston CCG

Telephone: 01772 214 200


Lancashire North CCG

Telephone: 01524 519369


West Lancashire CCG

Telephone: 01695 588000










CHANGE

This easy read document was produced by CHANGE

All Images © CHANGE

www.changepeople.org

http://www.changepeople.org/

Pre consultation - Equality Analysis Report – New PHB Policy Date: Signature: Signed off (senior manager):

1. Scope of this Assessment:

This document is a ‘pre consultation assessment’ and its focus is:

• Early identification of issues liked to protected characteristics.

• Identify likely consultation routes , methods and needs linked to Protected characteristics

• Issues that obfuscate and detract from person centred processes

Post consultation, evidence will be viewed and analysed

2. Details of service / function: Introduction of Personal Health Budgets for people that are eligable for Continuing Health Care within NHS parameters.

History

Following a successful pilot programme by the Department of Health, which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB.

This development mirrors other changes within the NHS, including the drive generally for greater patient choice, shared decision-making and innovation in managing funds. The Government has confirmed a commitment in the NHS mandate 2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015.

What is a Personal Health Budget (PHB)?

PHBs are the allocation of NHS funding which patients, after an assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people

to exercise choice and control over their lives is central to achieving better outcomes for individuals.

For Eligible 1Persons there is a duty on CCGs to:

• Consider any request for a PHB; • Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs. There are five essential characteristics of a PHB.

The person with the PHB (or their representative) must:

1. be able to choose the health outcomes they want to achieve

2. know how much money they have for their healthcare and support

3. be enabled to create their own care plan, with support if they want it

4. be able to choose how their budget is held and managed

5. be able to spend the money in ways and at times that make sense to them, as

agreed in their plan.

3. Change to service and potential discriminatory barriers

The ‘right to ask’ moving to the ‘right to have’ PHBs is the central concept, however; the policy needs to be clear on what this distinction means and how it can be tested.

Potential barriers leading to direct and indirect discrimination:

1. Inappropriate assessment (assessors not understanding needs identified by the individual/cares linking to wellbeing’)

2. Variation is quality of assessments (subjectivity).

3. Uneven access to the provision across the community.

4. Access to the provision difficult due to linguistic/ written material.

5. Poor data collection around equality and outcomes

All of the above factors cut across protected characterises of ‘ age, disability, Gender reassignment, marital status, race, religion, sex and sexual orientation’.

1 An eligible person is someone in receipt of NHS Continuing Health Care

4. Does this service go the heart of enabling a protected characteristic

to access health and wellbeing services? YES: the additional funding from PHB is to enhance the quality of life.

5. Consultation: Who do you need to consult and engage with?

External Consultation – Expectation to be completed by 29th January 2016

• Patient representation (being identified via LD, MH, Childrens’ commissioners & service users in receipt of PHB’s)

• Local Authority • CSU contracts and CHC • 3rd Party organisations • Carers Centre • NHS Community Providers

In addition to the above include:

1. Disabled people/Disability groups (Sefton CVS) Ensure that:

2. Monitoring process to capture protected characteristics. a. Test service providers on types of needs connected to different

protected characteristics ( e.g. men/women, ages , different disabilities, religions/Culture, BME

b. Service users: collect protected characteristics data as part of questionnaire/consultation.

3. Question user groups on: a. ‘how well do they think their needs are understood’ b. ‘how well do they think their needs are met’ c. ‘Have they been turned down for (PHB) funding in the past’ what did

they ask for? d. ‘What would be the likeliest use of funding should they receive it?’ e. ‘What do they think the biggest barrier to accessing the funding would

be?

6. Is there evidence that the Public Sector Equality Duties will be met

(a) Eliminate discrimination. – The guidance needs to establish processes to ensure that:

i. Eligible Patients requests will be given unbiased consideration.

ii.Variations across assessments can be identified and homogenised to ensure consistent and considered judgments

iii. Sub-optimal outcomes are interrogated as to why they are sub-optimal to eliminate subjectivity and unconscious bias of assessors.

(b) Advance equality of opportunity

In principle PHB offers opportunity’s to enhance life’s chances and quality of life, Results of consultation need to be evaluated before final assessment on whether PSED are met.

C Foster good relations between different protected characteristics- Not engaged.

7. Potential risks that need to be mitigated: Immediate action plan: Risk 1 • Revise policy to ensure it is clearly understood what the

difference and meaning is between ‘right to ask’ and ‘right to have’.

• Include definition of ‘eligible person’ • Highlight and make clear that PHB is not to cover

services and facilities as a result of the lowering of Social Care payments by LA

Risk 2 Identify processes within the policy to ensure assessments are non-discriminatory

Risk 3 Identify user groups to include in consultation plans

Risk 4 Ensure that service providers identify issue linked to different protected characteristics.

Risk 5 • Ensure consultation process is accessible and uses different formats.

• Ensure consultation incorporates minority groups • Ensure that consultation can record inputs by protected

characteristics ( to enable disaggregated analysis) Risk 6 Ensure consultation with service users included questions (or

questions of that type) highlighted above at section 4.3.

agenda item 4a - sefton councilmodgov.sefton.gov.uk/moderngov/documents/s65400/agenda item 4 a...

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