For the last three years, the NHS has piloted the concept of personal health budgets in specified areas, for specified groups of people. The Government has now committed to rolling these out nationally, focussing initially on those entitled to NHS continuing healthcare.
At the heart of personal health budgets is a care plan which helps to identify an individual’s health and wellbeing goals. Personal health budgets can then work in three different ways or as an amalgamation of these methods:
- Notional budget: no money changes hands. An individual is told how much money is available and can discuss with the NHS team the different ways to spend that money. NHS commissioners continue to arrange the agreed care and support
- Real budget held by a third party: a different organisation holds the money for the individual and helps them to decide what they need. The third party then commissions the care and support needed
- Direct payment for healthcare: cash is provided to an individual for them to buy the care and support they need. This is only lawful in certain areas which are pilot sites under secondary legislation. There are regulations that eligible PCTs need to follow when direct payments are used (The NHS (Direct Payments) Regulations 2010). Guidance has been issued by the DH (Direct payments for health care: information for pilot sites)
An independent evaluation report into the pilot programme found that, the quality of life for people with a personal health budget improved, with some even seeing a drop in their attendance at hospitals. Personal health budgets allow individuals to have more input into the care that they receive: with the flexibility to allow them to decide to utilise a range of different therapies, personal care and equipment. There has already been some controversy in the press about this, including patients being able to purchase kittens with their direct payments!
The national roll-out announced by the Government following the independent evaluation report, means that by 2014, up to 56,000 people receiving NHS continuing healthcare will have the right to ask for a personal health budget. Clinical commissioning groups (CCGs), as the commissioners in the reshaped NHS landscape, will inevitably have to put in place robust checks and balances post April 2013 to ensure that they are able to support those entitled to a personal health budget. They will need to monitor arrangements to ensure appropriate safeguards are in place to ensure that the budgets are used in accordance with the care plan.
A public consultation will also be launched shortly on updating the regulations for direct payments, with a view to enabling these across the country from summer 2013.