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Personal health budgets
Tom, 18 and from Dorset, lives and works on the family farm. Tom lost
the use of his left side after a brain haemorrhage. With his personal
health budget, he was able to rehabilitate at home, rather than in
hospital. Combined with a return to physical work on the farm, this
approach helped Tom’s left-side functioning improve dramatically. He
returned to work six months earlier than expected.
I suffered a brain
haemorrhage in May
2011 and was left with
paralysis down my left
side, including no
feeling in my left hand.
At first I had to be in a
wheelchair.
After two weeks in a brain
injury unit, one possible next
move was to transfer me to
another unit with more
rehabilitation services. But I was
desperate to stay out of
hospital. I felt being back home
on the farm would help me
recover quicker. I wanted to get
back to my normal life as soon
as possible and to be able to
attend agricultural college.
It was Ray, a healthcare case coordinator from Dorset Primary
Care Trust personal health budgets
pilot, who introduced the idea
of using a personal health budget
to help me recover at home.
I worked with my consultant, a
psychologist and my family on a
discharge plan and my care
plan, to set out what I wanted
to achieve. My ultimate goal
was to be able to return to
work full time at the farm
within 18 months to two years.
An occupational therapist advised
what work I could manage.
Jobs around the farm, such as
moving bales of hay and preparing
solution for calves, would
encourage me to use my left
arm and hand. Fly-fishing was
something I enjoyed so we
listed it as a exercise because it
helps with motor control,
particularly when fixing bait to
a hook.
“My ultimate goal
was to be able to
return to work full
time at the farm
within 18 months
to two years.“
My personal health budget
included funds to pay for 30
hours per week of support from
a personal assistant. Because of
our remote location and that I
preferred to have someone who
knew me and the work on the
farm, we employed my sister.
She helped me around the
farm, when I drove the tractor
and fed the pigs. Keeping
active was key to improving
movement on my left side.
I also used my personal health
budget to attend hospital
physiotherapy sessions, see a
personal trainer twice a week at
a local gym, and go swimming.
All to build up my stamina and
muscle usage.
I took my personal health budget
as a direct payment which
helped us pay professionals.
Because I was 17 when I had
my accident my mum controlled
paying everyone, from a
separate bank account. Ray
helped, from working on my
care plan through to liaising
with the occupational therapist.
Treatment was reviewed every
month. All the services
combined to markedly improve
my left side. I am now able to
walk more steadily, I can run
and play five-a-side football!
The occupational therapist used
to visit twice weekly. But as I
got better, this was reduced to
weekly. Now it’s once a month.
In April I returned to work fulltime on the farm. This was at
least eight months ahead of my
original forecasted return. In
reality, I was back to work parttime within three months! I am
also now able to attend college.
The personal health budget
enabled me to organise my care
and achieve what I wanted at
home. Without it, I could have
got back so much use from my
left side in the time that I have.
Dr John Burn, a consultant
in rehabilitation and brain
injury, says that a personal
health budget resulted in a
better-than-expected
outcome for Tom.
The personal health budget
enabled Tom to personalise his
treatment, giving him and his
family much more choice.
Plus, Tom and his family could
recruit specialist professionals
such as the occupational
therapist who was able to devise
a treatment programme for
Tom at the farm and supervise
his rehabilitation there.
With the use of a personal
health budget, Tom’s progress
has been faster than might
have been expected. For this
reason, his health outcomes
have been better.
Roger Webb, project manager
for the NHS Dorset pilot, says
personal health budgets are
encouraging providers to
think differently about how
services are provided.
A personal health budget
enabled us to source the
person-centred care Tom
wanted and would help him.
Our community rehabilitation
team would normally have
struggled to provide for Tom at
his remote farm location. But,
in particular, a personal health
budget enabled an independent
occupational therapist and a
personal assistant who knew
Tom and the farm environment
to be employed. Personal health
budgets are encouraging us to
change the way we think about
providing services. This really
has brought great health
outcomes for Tom.
A personal health budget allows people to have
more choice, flexibility and control over the
health services and care they receive.
The Department of Health thanks the people and families
concerned for sharing their personal stories. For further
information please contact:
Kym Lang, communications manager
Personal health budgets pilot programme
tel: 020 7210 5091
email: personalhealthbudgets@dh.gsi.gov.uk
web: www.dh.gov.uk/personalhealthbudgets