Wiltshire CCG Personal Health Budgets: Local Offer
What is a Personal Health Budget? >
A personal health budget (PHB) 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.
At the centre of the personal health budget is a personalised care and support plan. This sets out the health and wellbeing outcomes that the patient wants to achieve as agreed by both the person and their local NHS team, and how the personal health budget will be spent to help the individual.
Co-production and Personal Health Budgets
Personal health budgets aim to enable people to proactively manage their health; a process known as co-production, which is where the individual and health professional(s) work together as equal partners in deciding how to achieve personal goals.
The process of developing a personalised care plan may lead to people utilising existing services which are already in place and can meet their needs, or it may result in using personal health budgets in innovative ways to meet their health care needs.
At the core of a PHB is a person led care and support plan, agreed between the NHS and the budget holder, which considers the holistic needs of individuals, viewing these in the context of their broader lives.
More choice and control
The aim of a personal health budget is to give individuals more choice and control over the money spent on meeting their health and wellbeing needs.
Personal Health budgets support the vision of a more personalised, patient-focused NHS.
What can a Personal Health Budget be spent on? >
A personal health budget can be spent on care or services that are set out in the person led care and support plan that has been put together with the NHS team or voluntary organisation working with the person – and this needs to be agreed by the CCG
What it doesn’t cover
There are things that it would not be right for the Government to fund such as:
- Debt repayment
- Anything that is illegal
A personal health budget cannot be used to buy emergency care; for example if someone in receipt of a personal health budget had an accident, they would go to A&E to seek assessment and any required treatment. This treatment is already funded through other contracts.
A personal health budget cannot be used to purchase primary medical services provided by GPs, as part of their primary medical services contractual terms and conditions nor is it suitable for the following public health services:
- Vaccination or immunisation, including population-wide immunisation programmes.
- The national child measurement programme
- NHS Health Checks
Who can have a personal health budget? >
From 2014, patients eligible for NHS continuing health care (CHC) (including children’s continuing care) had the right to request a personal health budget.
From the 1st of April 2015 those with a long term condition (including mental health conditions; aged 18+) have also had the right to request a personal health budget.
Children & young people
Wiltshire CCG is currently providing a small number of PHBs to children who are eligible for children’s continuing care and who are in receipt of Direct Payments from Children’s Social Care. The CCG and Local Authority work together to make this a straight forward, streamlined process for parents carers. The Council takes the lead in setting up the Direct Payment/Personal Health Budget as all the children eligible for children’s continuing care are also supported by the Council’s SEN and Disability Service. The CCG and the Council work with Wiltshire Parent Carer Council to promote personalisation, including Personal Health Budgets (WPCC is a parent-led organisation with 1,700 members who are all parents of children with a special educational need/disability). A significant percentage of WPCC’s membership will have children with Education, Health and Care Plans under the SEND reforms contained within the Children and Families Act 2014.
What is changing?
The developments relating to personal health budgets mean that all patients in the above categories will be able to request a personal health budget. Wiltshire CCG will implement a phased rollout of PHBs on a test and learn basis.
During 2016 and 2017 Wiltshire CCG will be taking part in the Integrated Personal Commissioning collaborative programme led by NHS England (see more details below). This programme will support the provision of between 15-25 personal health budgets to individuals with the highest complex needs for those with severe mental health condition, long-term health conditions, in addition it will include people with learning disabilities and or Autism ; eligibility criteria and further details will be developed and published on this website page as the programme progresses.
The CCG is undertaking a detailed analysis to understand how it can support patients to take greater control of their own care and in the future hopes to increase the numbers of patients with their own personal health budgets. Further details relating to this will be provided as the work relating to personal health budget delivery progressing during 2016/2017.
Wiltshire CCG aim to support every patient and, whilst we are not always able to provide them with a personal health budget which results in a direct payment; NHS professionals
can work with them to identify ways to create a personalised care plan, putting them at the heart of their own healthcare decision making.
A goal detailed within the NHS Planning Guidance is that 50-100,000 people nationally should have PHB by 2020.
Integrated Personal Commissioning Programme >
Integrated Personal Commissioning (IPC) is a way for the NHS to offer person led care and support beyond Continuing Healthcare to a variety of individuals who could benefit. IPC is a new approach to person-centred health and social care that endeavours to put people in control, to enable them to live well at home and to encourage integration at an individual level. Personalised care planning, at the heart of the IPC programme, involves joint-working between individuals, families and professionals to set personalised health outcomes and to shape services around people. The broad prospectus of IPC is to shift focus from ‘what’s the matter with you’ to ‘what matters to you’.
Wiltshire CCG has become part of the South West Integrated Personalised Commissioning Programme, launched in the Five Year Forward View.
The aims of this programme are:
- To support people with complex needs and their carers to have a better quality of life and to achieve the outcomes that are important to them and their families
- To prevent crises in people’s lives that lead to unplanned hospital admissions.
- To encourage better integration and quality of care
The programme is aimed at groups of individuals who have high levels of need across both health and social care. A personalised approach would address acknowledged problems in current care provision, help prevent people from becoming more unwell, and enable people to retain their independence.
- Children and young people with complex needs, including those eligible for Education, Health and Care (EHC) plans
- People with multiple long-term conditions, particularly older people with frailty
- People with learning disabilities and or autism with high support needs, including those who are in institutional settings or at risk of placement
- People with significant mental health needs, like those eligible for the Care Programme Approach or who use significant amounts of unplanned care
Integrated Personal Commissioning is based on two core elements:
- Care Model: Person-centred care and care planning, combined with an optional personal health and social care budget
- Financial Model: An integrated ”year of care” capitated payment model
The new IPC programme builds on existing initiatives, for example Personal Budgets, Better Care Fund, The Special Educational Needs and Disability (SEND), and has a number of key roles for voluntary and community sector organisations.
Personal Budgets are at the heart of the post Winterbourne View Transforming Care agenda. The new Wiltshire and Swindon Transforming Care Partnership Service Model plan has clear focus on personalisation. A clear goal and priority will be the roll out of personal health budgets for people with Learning Disabilities and or Autism who have the most complex needs.
Local and regional implementation >
Organisations taking part in this new approach will implement between 15-25 personal health budgets to gather information on what works well with the lessons being shared across the region. Over the next 18 months the expansion of Personal Health Budgets and integrated budgets will progress in a careful and phased way. Wiltshire CCG will provide further specific details about the cohorts it will be able to provide personal health budgets for during 2016/2017 as we progress with the pilot.
As outlined above, Wiltshire CCG will extend Personal Health Budgets to individuals in a planned way to ensure that learning is captured. The CCG will be in a better position to describe plans for 2017/18 and as such this report will be refreshed by March 2017 to include learning from early implementation, progress to date and an update on the CCG’s local offer.
I am interested in a Personal Health Budget – what should I do? >
If you are interested in a PHB for CHC or children/young people the first step is to talk to your NHS professional about your request.
Further details will be developed and published on this website page as the Wiltshire CCG PHB IPC programme progresses throughout 2016/2017.