The National Personal Health Budget Pilot Programme

Working together for a healthier Nottingham

The National Personal Health Budget Pilot Programme

Gemma Newbery‘NHS Personal Health Budget’ Project

Manager


What is a Personal Health Budget? (PHB)

A Personal Health Budget (PHB) is an amount of money that is allocated to a patient. The patient has choice and control over how this money is spent to meet their own personal and clinical outcomes.


Positive lessons from social care

Promising international evidence

Very new to the NHS

•A firm commitment to personal health budgets

•But begin by piloting

•Take time to evaluate, finding out what works

•Build on what works in other areas and link with them

Many risks and complexities

Personal Health Budgets (PHBs) are one part of the drive to personalise public services in general, and health services in particular. They are a way to allow people to take more control over how money is spent on their healthcare.

evidence of the benefits of personalisation

Who benefits most

Where have PHBs Come From?


-Hartlepool PCT with Stockton PCT-Doncaster PCT-Hull Teaching PCT-Manchester PCT-Merseyside (joint bid)-Stoke on Trent PCT-Health and Wellbeing Partnership, Birmingham-Barking and Dagenham PCT-Havering PCT-West London PCT

- Dorset PCT-Norfolk PCT-NHS Nottingham City-Northamptonshire Teaching PCT-Oxfordshire PCT-Avon, Gloucestershire, Wiltshire and Somerset Cardiac and Stroke Network-Bedfordshire PCT-Eastern and Coastal Kent PCT-Medway PCT-Torbay Care Trust

NHS Personal Health Budget Pilot Sites


Nottingham’s NHS Personal Health Budget Pilot

To explore the use of Personal Health Budgets for:

• Patients with neurological conditions referred to the new Community Neurology Service

• Patients with memory problems referred to the Intermediate Care Service at the Willows

• Patients that become eligible for fully funded NHS Continuing Health Care or joint funded care packages

• Carers of patients receiving a Personal Health Budget


NHS White Paper Spending review Mental health strategy

Carers’ strategy

SEN Green Paper

Right to Control

NHS Operating Framework.

Clear Government Support for PHBs

NHS Future Forum and the Government’s

response

October 2011 announcement that, subject to the evaluation, people

receiving NHS Continuing Healthcare will have a right to ask for a personal

health budget by April 2014


PHBs: Key Points

• At the heart of a personal health budget is a care plan which is developed in partnership. Bringing together the clinical knowledge and expertise of professionals in partnership with the individual’s knowledge of how their condition affects them and what works for them.

• The plan and the budget enables people to meet their needs in different ways, ways that work for them. Once it has been developed, the plan will be subject to clinical governance and sign off.

• Personal health budgets are not about new money; rather they use money which would have been spent on an individual’s care in different ways.

• Personal health budgets aim to deliver better health and wellbeing outcomes through choice and control. They should facilitate integration across services.


Step by Step Journey


5 Steps

1. How much?2. Support Plan3. Agree the Plan4. Organise Support5. Review


Step 1- How Much?

• Based on the cost of providing the patient with commissioned services

• Continuing Health Care Resource Allocation System


Step 2 – Support Plan

• Self Brokerage• Brokerage

– Internal (NCC)– External

• Directory of Services:– www.dowhatyouwant.org– www.nottinghamcity.nhs.uk/-your-services-/

personal-health-budgets.html


Step 3 - Agree the Plan

Step 1 – Clinical sign off by lead clinician

Step 2 – Commissioning sign off


Step 4 – Organise the Support

Notional individual

budget

Real budget held on the individual’s

behalf

Direct payment – cash held by

patient

Mo

re direct co

ntro

l to

ind

ividu

als

Already legally

possiblePersonal care plans


Step 5 - Review

• Review periods based on:– Patient’s condition– Risk– Clinical Agreement– Support Plan Period


Patient Examples: Mental Health

• Pete’s Story – DVD


Early Lessons & Key Challenges - 1• It is essential that health and social care work

together to facilitate personalisation

• Personal Health Budgets aren’t for everyone

• People want help to develop a support plan and decide how to spend their budget

• Support planning is time consuming if it is done properly

• Fluctuating and changing need


• The culture change to facilitate personalisation in health is huge

• It is important to recognise and record risks

• Market development

• Delivering Personal Health Budgets in a time of financial challenge

• Developing the right systems and processes

Early Lessons & Key Challenges - 2


What Next - 1?

To build on the lessons learnt throughout the PHB pilot to develop a sustainable, efficient and effective process for providing patients with a PHB in Nottingham.


What Next - 2?

• Roll out for patients eligible for Continuing Health Care • Roll out for joint funded patients• Continue to offer PHBs to patients with neurological

conditions accessing the Community Neurology Service

• Explore PHBs in children’s continuing care• Explore PHBs in mental health, short term residential

care• Explore PHBs with patients with working age dementia

living in the community• Explore PHBs for people with ME


Any Questions?

Gemma Newbery

Email: [email protected]

Tel: 0115 883 9474

Documents

The National Personal Health Budget Pilot Programme