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.
At the core of a personal health budget is a person-led care plan and support plan, agreed between the NHS and the budget holder. It considers the holistic needs of individuals in line with the context of their broader lives.
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.
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 put together with the NHS team, local authority, or voluntary organisation working with the person. Proposed spending needs to be agreed by the Clinical Commissioning Group.
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 – if someone in receipt of a personal health budget had an accident they would go to A&E for assessment and any required treatment.
- Secondary in-patient care – for example, elective surgery.
- Primary medical services – those provided by GPs as part of their primary medical services contractual terms and conditions.
It is also not 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 (including children’s continuing care) have the right to request a personal health budget.
From the 1 April 2015, those patients with a long term condition (including mental health conditions; aged 18+) have also had the right to request a personal health budget.
Children and young people
Wiltshire CCG currently provides 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. We work together with Wiltshire Council 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 Special Educational Needs and Disability (SEND) Service. Along with the Council, we work with Wiltshire Parent Carer Council (WPCC) 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. We will implement a phased rollout of personal health budgets on a test and learn basis.
We are completing a detailed analysis to understand how personal health budgets 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 delivery progresses.
Wiltshire CCG aims to support every patient and, whilst we are not always able to provide them with a personal health budget which results in 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.
As part of our analysis, we will be considering how we can help with the following:
- Children and young people with complex needs, including those eligible for Education, Health and Care 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 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.
A goal detailed within the NHS Planning Guidance is that 50-100,000 people nationally should have a PHB by 2020. Wiltshire CCG has undertaken to implement their share of their residents on a pro-rata basis.
Partnership working >
We work closely with our providers and local authorities and voluntary organisations to deliver personal health budgets that support a person’s identified health and wellbeing needs.
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.
I am interested in a Personal Health Budget – what should I do? >
If you are interested in a personal health budget for continuing health care, or children/young people the first step is to talk to your NHS professional. They will discuss with you whether a personal health budget is right for you and whether the processes are already in place to meet your specific needs.