Paul Burstow announces more power for patients in personal health budget pilot

From the Department of Health comes this news:

Patients will be offered more choice and control over their healthcare with the launch of the first direct payment scheme, Care Services Minister Paul Burstow announced today.

Eight Primary Care Trusts will begin to road test direct payments for personal health budgets. This will allow Primary Care Trusts to give the money for someone’s care directly to them, allowing individuals to decide how, where and from whom they receive their healthcare, in partnership with the local NHS.

Previously, personal health budgets could only be held by a Primary Care Trust or third party.

The cost of providing direct payments will come from existing funding within PCTs. Existing evidence from social care suggests that personal budgets are cost neutral across the system. Direct payments can be paid to patients in a number of ways, including monthly direct payments or a lump sum for a one off purchase such as a piece of equipment.

The scheme is designed to help individuals with a range of health conditions including people with diabetes, stroke, heart disease, end of life care and mental health conditions.

People can use their personal budgets in a number of ways. For example, one patient who suffers from chronic pain following removal of a spinal tumour uses her personal health budget for long term, extensive massage and hydrotherapy sessions to relieve chronic pain without the side effects of painkilling drugs, drowsiness and disorientation.

Another patient’s personal budget enabled him to spend his last few months at home with his daughter and grandchildren. The budget was used to provide flexible care while his daughter was at work, rather than the more traditional four times a day short visits.

Piloting direct payments is part of a wider programme testing personal health budgets. More PCTs will be authorised to offer direct payments over the coming year. The pilot programme will inform decisions around how to proceed with wider, more general roll-out.

Care Services Minister Paul Burstow said:

This is an important step towards putting patients at the heart of everything the NHS does.

Direct payments have real potential to improve the lives of individuals with long-term health needs by putting treatment choices in their hands. That is why we are driving forward the commitment in the Coalition Agreement to extend access.

There is strong evidence from the social care sector that direct payments help achieve better outcomes, and give people more choice and control over the care they receive. It also encourages a more preventative approach. It is a step away from the rigidity of the Primary Care Trusts deciding what services a patient will receive.

Direct payments will not work for everyone or for all patient groups or services, but we want to identify whether, for whom and how they could offer an opportunity to help achieve the best health and wellbeing outcomes. That is why we are developing this pilot programme.

It will stop healthcare from slipping back to the days of one-dimensional, like-it-or-lump-it services.

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2 Comments

  • Well, it sounds like brilliant doctoring to me but wait, what’s this? Just down the road at the British Medical Association there’s an almighty clamour! Doctors are revolting and have just voted overwhelmingly in favour of removing homeopathic treatments from the NHS.

    According to Nursing in Practice and a number of other esteemed journals, the British Medical Association (BMA) conference have just voted against the continuation of homeopathy on the health service and called for the financial support of four UK homeopathic hospitals to be removed.

    Are the two by any chance related? I think we should be told! But in the meantime…you decide.

    http://newsmanagement.blogspot.com/2010/06/not-what-doctor-ordered.html

  • While the principle will chime with liberal values, as someone working in this field I urge caution. My liberty cannot be exercised if it reduces the freedoms and rights of others.

    The statement “evidence from social care suggests that personal budgets are cost neutral” is flimsy at best. In most cases Local Authorities put additional money into the pilots, so as not to visit the consequences of people making different choices on how to spend their money on others.

    Health and social care are fundamentally different, because in health spending, if someone spends unwisely and then needs to exceed their budget, nobody will deny them access to care. That is what “free at the point of need” means. For example if I spend my personal budget on a holiday for my hard pressed carer, rather than skilling myself to self-manage my diabetes, so I continue to incur the higher NHS costs of more admissions to hospital that the self management course would have prevented, guess what? The NHS foots the bill and my spending exceeds my personal budget (and encroaches on somebody elses)

    When day care centres close because 30% of the people previously attending them now use their direct payment on other things so it is no longer economic to run for the 70% who still wish to use the centre, then where is the patient power? A minority have dis-empowered the majority.

    Direct payments and personal budgets have great potential when used intelligently in a careful, targeted way. Having the understanding of health and social care economics to determine where best to apply them is highly skilled. What a shame our party finds itself in coalition with a tory party that does not wish to retain these skills and is scrapping them.

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