DH plans rollout of personal health budgets

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confusion The Department of Health has outlined plans to make personal health budgets (PHBs) available to the 56,000 people receiving NHS continuing healthcare from April 2014.

It also anticipates that CCGs will offer PHBs to millions of people with long-term conditions.

However, it has admitted that no training or infrastructure exists to make this transformation of NHS care provision work.

A more fundamental change than the NHS reforms, the introduction of personal health budgets makes patients responsible for commissioning their own care.

Based on a three-year pilot study with 2,700 patients in 20 sites, the DH is confident that this system will reduce GP visits and hospital admissions, and so cut the cost of NHS care.

Patients will receive an agreed sum of money and will be responsible for designing a care package and choosing providers.

NHS continuing healthcare is provided outside hospital for people with ongoing healthcare needs – i.e. people with a complex medical condition that requires a lot of care, including specialised nursing support.

At a conference organised by the Westminster Health Forum, the DH’s PHB team leader Alison Austin said the new system offers “fantastic opportunities” for integrated care with better outcomes at less cost.

However, she said, healthcare providers currently lack the capacity to manage this “huge” change in the organisation of NHS care.

Other speakers at the conference discussed the challenge of taking responsibility for patient care out of the hands of clinicians.

Sarah Carr, a senior analyst at the Social Care Institute for Excellence charity, noted that patients choosing their own care package would represent “a really big challenge for clinicians schooled in evidence-based medicine”.

Jay Dobson, one of the organisers of the PHB pilot scheme, said the new approach would “revolutionise” NHS care – but at present, providers were unaware of it, and the healthcare market was not ready to provide that level of choice.

Further aspects discussed included the role of the voluntary sector (supported by CCG funding) in helping patients to manage their options; and the need for legal support to help commissioners draw up contracts.