essentials of personal health budgets€¦ · 4 aim of personal health budgets • to give people...
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www.england.nhs.uk
Essentials of
personal health
budgets
7 March 2019
Steven Pruner
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www.england.nhs.uk
Overview of PHBs
Show an example
Questions
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What is a
personal health budget?
“A personal health budget is an amount of
money to support a person’s identified health
and wellbeing needs, planned and agreed
between the person and their local NHS team.”
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Aim of personal health budgets
• To give people greater choice, flexibility and control
over the health care and support they receive
• An opportunity for people to work in equal
partnership with the NHS about how their health and
wellbeing needs can best be met
• Personal health budgets are not about new money,
but about using resource differently
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Principles
• NHS values still hold
• No entitlement to ‘more’
• Services should be safe
and effective
• Personal health budgets
should be a positive
experience
• Access to services that
best suit the individual
• Control over decision
making
• Not mandatory
• Support planning is key
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What can they spent on?
Anything agreed in a personalised care and support
plan which will meet health and wellbeing outcomes, for
example:
• Equipment
• Personal care
• Complementary therapies
• Supportive technology, e.g. computers, iPads
Services should be appropriate for the State to provide
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What is excluded?
• GP services (GP contract)
• Acute unplanned care (including A&E)
• Surgical procedures
• Medication
• NHS charges e.g. prescription charges
• Vaccination/immunisation
• Screening, diagnostics
• Gambling, debt repayment, alcohol, tobacco
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The five parts summary ….
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Options to manage the budget
Notional Budget
Money is held by the NHS
Third Party Budget
Money is paid to an
organisation that holds the
money on the person’s behalf
Direct Payment
Money is paid to the person
or their representative
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Indicative budget
• Best estimate of how much assessed care / services will
cost
• In continuing healthcare should be similar to that of a
traditionally commissioned package
Acronym CUTE will ensure a successful indicative budget
• Clear
• Upfront
• Transparent
• Enough
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Personalised care and
support plans
• Who, if at all, does person want to support them in PHB
process?
• Focus on whole life, not just health needs
• Consider background & culture of person receiving care
• Consider education, employment, social interactions
• Contingency to be included
• It is a contract between person receiving care & NHS
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Other considerations
• Current care provision and funding arrangements
• Risk assessment: clinical and financial, compliance with
statutory requirements
• Process for CCG to take over funding:
o Self-funded arrangements
o Social care direct payments
• Open and transparent communication with the person /
family about what PHBs mean for them: what stays the
same or may need to change
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PHBs in numbers
• 50-100,000 by 2020/21 – NHS Mandate
• 200,000 by 2023/24 – NHS Long Term Plan
• 40,344 PHBs currently – end of Q3 2018/19
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Diversification of PHBs
Continuing
Healthcare
Mental Health
including
S117
Choice in End
of Life Care
Looked After
Children
Wheelchairs
and other
specialist
equipment
Substance
Misuse
Neurological
disability
People with a
learning
disability
Integrated
Budgets
Veterans
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PHBs in London Q3 2018/19
316
193
106
2386
Totalchildren
ContinuingCare
ECHP LD/Autism Other
Children2562
1339
401244
532715
Total adults ContinuingHealthcare
Joint MentalHealth
LD/Autism Other
Adults
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PHBs in London Q3 2018/19
35%
7%
58%
How the budget is managed
Direct Payment Third Party Notional
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People’s experience
Quality Health survey of 390 PHB
holders in 2018:
• 77% would recommend PHBs
• 89% said PCSP reflected what
matter to them
• 86% achieved what they wanted
• 60% process too slow
• 41% difficult to get PHB information
• 47% hard to recruit PAs
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Better quality of life
https://www.youtube.com/watch?v=9xw6pWJV0kQ
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Questions / Discussion
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Further information & support
• NHS England website
https://www.england.nhs.uk/healthbudgets/
• Personal Health Budgets Learning Network
www.personalhealthbudgets.england.nhs.uk/login
• Personalised Health and Care Framework
https://www.england.nhs.uk/personalised-health-
and-care/
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