The National Personal Health
Budget Pilot Programme
Gemma Newbery
‘NHS Personal Health Budget’ Project
Manager
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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.
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Where have PHBs Come From?
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.
Positive lessons from
social care
•A firm commitment to
personal health
budgets
Very new to the
NHS
•But begin by piloting
Promising international
evidence
evidence of the benefits of
personalisation
•Take time to evaluate,
finding out what works
•Build on what works
in other areas and link
with them
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Many risks and
complexities
Who benefits
most
NHS Personal Health Budget Pilot Sites
-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
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- 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
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
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Clear Government Support for PHBs
NHS White Paper
SEN Green
Paper
Spending review
Mental health strategy
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
Carers’ strategy
Right to
Control
NHS Operating Framework.
NHS Future Forum
and the Government’s
response
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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.
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Step by Step Journey
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5 Steps
1.
2.
3.
4.
5.
How much?
Support Plan
Agree the Plan
Organise Support
Review
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Step 1- How Much?
• Based on the cost of providing the patient
with commissioned services
• Continuing Health Care Resource Allocation
System
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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
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Step 3 - Agree the Plan
Step 1 – Clinical sign off by lead clinician
Step 2 – Commissioning sign off
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Step 4 – Organise the Support
Personal
care
plans
Real budget
held on the
individual’s
behalf
Direct payment
– cash held by
patient
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Already
legally
possible
More direct control to
individuals
Notional
individual
budget
Step 5 - Review
• Review periods based on:
– Patient’s condition
– Risk
– Clinical Agreement
– Support Plan Period
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Patient Examples:
Mental Health
• Pete’s Story – DVD
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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
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Early Lessons & Key Challenges
-2
• 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
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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.
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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
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Any Questions?
Gemma Newbery
Email: gemma.newbery@nottinghamcity.gov.uk
Tel: 0115 883 9474
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