Personal Health Budgets Dawn Stobbs September 2014

Presentation will include :- What is a personal health budget? How do they fit with the choice agenda in the NHS? What do we know so far about personal health budgets. Government commitments and legislation for personal health budgets. Personal health budgets support programme.

Choice and Control Expert patient programmes Personal Health Budgets Self Care Person Centred Care Planning Information Standard Peer support Choose and book Co- production Shared Decision Making Activated patients Patient Decision Aids Information prescriptions Integration Year of Care Information as a service Choice and Control Designed by Sarah Walker – Enable East

What is a Personal Health Budgets? 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. The vision for personal health budgets is to enable people with long term conditions and disabilities to have greater choice, flexibility and control over the health care and support they receive. Personal health budgets offer the 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

They can be managed in 3 ways Options for holding the budget: Notional budget Third party budget Direct payment

The Story So Far. Pilot programme - large scale controlled trial evaluation 2009-2012. Recruited 2,000 people. Concentrated on Mental Health, Continuing Health Care, COPD, Diabetes, long term neurological conditions, stroke. Also discreet studies into maternity, substance misuse and end of life care. Results - better outcomes, reduced use of hospital, cost effective especially for people with the highest needs.

Government Commitments Right to ask from April 2014 - in adult NHS Continuing Healthcare and children’s continuing care. Right to have from October 2014- same groups as above. NHS Mandate - will be an option for people with long term physical and mental health conditions who could benefit from April 2015. Direct payment regulations– NHS everywhere in England can offer direct payments from August 2013. CCGs have the responsibility for delivery even if Continuing Health Care/continuing care services are being delivered by CSUs.

Need to do it right. Evaluation - benefits of personal health budgets depend on how they were introduced. Best results – people know budget up front; advice and support available; choice and flexibility over how to spend budget , choice on how it is managed. Scale-up - challenge of maintaining the integrity of the values. To work well, personal health budgets need good support from all parts of the system. co-production with people with direct experience.

Examples Employing personal assistants Alternative respite and day care provision None standard equipment and services Alternative health and wellbeing provision Joint packages for health and social care

Integrated Personal Commissioning Programme Announced by Simon Stevens in July. Integration at the level of the individual across health and social care. Person centred planning and personal budgets across health and social care. Capitated (individual level) budgets for their health and social care. Children and Young People with complex needs, people with multiple LTC, LD with high support needs and MH. In partnership with the voluntary sector.

Delivery Support Delivery support around the country. Work looking at specific issues or areas where we need to learn more e.g. children, learning disabilities, budget setting, integration, workforce. More work to learn from and join up with other similar programmes and developments e.g. Special Educational Needs and Disabilities (SEND) pathfinder project. Continue to share learning and stories via the PHB toolkit and website. Bring people together to network and share.

Support for developing PHBs for Children NHS England has:- commissioned In Control to work with 4 CCGs to develop approaches to mainstreaming personal health budgets for young people, children and families (health, social care and education) Dorset, East Sussex, Trafford and Nottinghamshire. commissioned Council for Disabled Children to develop practical tools for introduction of SEND reforms into health – 3 events happening around the country in September and October to introduce new resources. Ongoing programme of regional events aimed at people working alongside young people, children and families about how to introduce personal health budgets within the context of personal budgets in an EHC plan. Three regional events in January, February and March to provide more in-depth introduction to implementing personal health budgets for children.

Contact Details Dawn Stobbs Patient Participation Team Dawn.stobbs@nhs.net 07876 851775 Kirsty Freeman -North East Kirsty.freeman1@nhs.net Personal Health Budget website www.personalhealthbudgets.england.nhs.uk Evaluation Team website www.phbe.org.uk