1. Chester Ellesmere Port & Neston Rural Making sure you get the healthcare you need Personal Health Budgets (PHB) Gus Cairns – Patient Leader, Being Well Helen Ashcroft – Head of Commissioning January 2015

2. Making sure you get the healthcare you need  Patients with Continuing Health Care and Children with Complex Care - from October 2014  Children and Young People with an Education and Health Care Plan - from September 2014  Extended to long term conditions - from April 2015  Pilot sites are being sought for new Individual Personal Commissioning National Direction

3. Making sure you get the healthcare you need  PHB for Continuing Health Care have been offered since 2009 – currently about 30 patients have taken up the offer  PHB for Children with Complex Care needs went live in October. So far one family has discussed having a PHB  Joint commissioning discussions are taking place with the Local Authority for special education needs PHB.  West Cheshire CCG have submitted a bid for the Individual Personal Commissioning  Mental health services are keen to progress PHB and are looking closely at how to move forward Local progress

4. Making sure you get the healthcare you need  There is no definition from NHS England on what are considered ‘long term conditions’  NHS Mandate from April 2015 that people with long term conditions who could benefit should have the option of a personal health budget  The National Health Service Clinical Commissioning Groups (Responsibilities and Standing Rules) (Amendment) Regulations 2013 sets out CCGs’ legal duties including:  Duty to consider any request for a personal health budget;  Duty to inform people eligible of their right to ask for a personal health budget;  Duty to provide information, advice and support in relation to personal health budgets. Long Term Conditions

5. Making sure you get the healthcare you need Distinctive features: The patient will first have a discussion with their clinician and agree that there is a need Outcomes focused – as part of the discussion it must be clear what the outcome of the PHB would be In collaboration the clinician and patient (often with the help of a third party facilitator) work together to develop a plan The patient’s choice must be taken into account The plan will be regularly reviewed. What is a PHB?

6. Making sure you get the healthcare you need The PHB process

7. Making sure you get the healthcare you need  Practical examples:  A lady who was being sectioned 3 times a year used a PHB to pay for a summer house in the garden and was no longer sectioned. Cost savings to NHS and better outcomes for patient  A dementia patient reacted aggressively to TV commercials, requiring input from the challenging behaviour team. A PHB was used to fund a Sky Plus box to fast forward the adverts. Cost savings to NHS and better outcomes for patient How does it work?

8. Making sure you get the healthcare you need  Farmer who couldn’t return home post stroke due to his rehabilitation needs. A PHB funded his return home by adapting his environment and having a GPS. Cost saving as a rehab bed was freed up, and better patient outcomes. How does it work (2)?

9. Making sure you get the healthcare you need  Implementing the change – commissioning and provision  Looking to the future  Robust systems to help patients  Transparency  Sustainability  Market development  Listening to and learning from patients Challenges

10. Making sure you get the healthcare you need  Are PHB easy to understand?  Might there be a demand for PHB?  Would a specific area be best to pilot PHB?  How could we raise patient awareness?  How could the PPG help with PHB?  Would should our next steps be? Discussion