Overview of Personal Health Budgets Gail Bravant & Jason Yates January 2016

Background to Personal Health Budgets Piloted in 2009-12 within the NHS Gives people more choice and control over the healthcare services they receive Part of the larger Personalisation agenda, emphasis on person-centred care Government commitment to expanding PHBs based on learning from the pilot

What is a Personal Health Budget? Five essential parts of a personal health budget: Know upfront how much money they have available for healthcare and support. Be enabled to choose the health and wellbeing outcomes they want to achieve, in dialogue with one or more healthcare professionals. Be involved in the design of their care plan. Be able to request a particular model of budget that best suits the amount of choice and control with which they feel comfortable. Be able to spend the money in ways and at times that make sense to them, as agreed in their plan.

3 ways of receiving a Personal Health Budget Notional budget – the person is advised of the amount of money which would have been spent on traditional services, to meet their needs. They discuss with the named professional alternative ways to meet their needs based on the same budget. The alternative is then proposed to the CCG. If approved, the professional arranges the care and support for the patient. No money changes hands. Third party budget – the money is paid to an organisation that is independent of the individual and the NHS, manages the budget on the person's behalf, and arranges support by purchasing services in line with the agreed care plan. Direct payment (for health care) – a direct payment is a monetary payment to a person (or their representative or nominee) funded by the NHS to allow them to purchase the services agreed in the care plan.

Who can have a Personal Health Budget? Since October 2014, people receiving NHS Continuing Healthcare and Children and Young People’s Continuing Care have had the ‘right to have’ a personal health budget. By April 2016, CCGs are expected to expand personal health budgets and joint personal budgets across health and social care for people with learning disabilities who have complex needs and children with special educational and disabilities as part of their integrated education, health and care (EHC) plans. CCGs should also consider other groups who could benefit from the flexibility of a personal health budget (e.g. in mental health, long term conditions).

Challenges Financial Managing the impact on existing services. Investment in infrastructure (e.g. systems, advice and support services, staff training). Stimulating the provider market. Cultural Making personal health budgets part of routine practice – personalisation is everybody’s business! Changing the relationship between health professionals and patients.

Next steps Review existing personal health budget processes. To understand what is/isn’t working well. 2. Engage widely and fully with local community and patients, including local Healthwatch. To determine which other groups could benefit from a personal health budget. 3. ST CCG to develop ‘local offer’ by 31 March 2016. This should be agreed by the Health and Wellbeing Board and published.