In this slideshow, Dr Alison Austin, head of the personal health budgets team at the Department of Health, outlines the different elements of a personalised health service and highlights the ways in which the personal health budgets initiative will be rolled out by the Government. Dr Austin presented at the Nuffield Trust seminar: Clinical commissioning versus individual commissioning: the role of personal health budgets?

1. Clinical commissioning v individual commissioning:
The role of personal health budgets
Nuffield Trust: 26 April 2012

2. PHBs are one part of the drive to personalise public
services in general, and health services in particular
Right to
Control
Personalise
pilots
d care Self-directed
planning support
Personal
health Personal
budgets budgets
in social
Choice, care
Special including
Educational choice of
Needs & provider,
Disabilities GP,
(SEND) treatment
pilots and
Choose &
Book

3. 5 Key Points
• At the heart of a personal health budget is a care plan which is developed in
partnership. Bringing together the clinical knowledge and expertise of
professionals in partnership with the individual’s knowledge of how their condition
affects them and what works for them.
• The plan and the budget enables people to meet their needs in different ways,
ways that work for them. Once it has been developed, the plan will be subject to
clinical governance and sign off.
• Personal health budgets are not about new money; rather they use money which
would have been spent on an individual’s care in different ways.
• Personal health budgets aim to deliver better health and wellbeing outcomes
through choice and control. They should facilitate integration across services and
build on other policies such as LTC personalised care planning.
• Personal health budgets are currently being piloted, direct payments for
healthcare are only lawful in DH approved pilot sites. But they will be rolled out
subject to piloting.

4. The PHB pathway is very similar to a number of others:
• Personal budgets in social care,
•SEND pathfinders
•LTC care planning
•Year of Care
level of
plan
need planning
assessment agreed commissioning
agreed process
But there are only a few differences e.g.
• when/if people know how much money is in there budget
• how budgets set
• means testing

5. Different ways of delivering a personal
health budget
Notional
More direct control to
individual
budget
Already
individuals
legally
Personal Real budget possible
care held on the
individual’s
plans behalf
Direct payment
– cash held by
patient

6. The Pilot Programme: involving people with a range of conditions:

7. Government is committed to national roll-out
2012-13 2013-14 2014-15 […] longer-term aim
Pilot
National roll-out from
evaluation A wider right
2013-14 (an objective for the
(October to ask for a
NHSCB)
2012) personal
health
budget, for
Right to ask for a those who
personal health budget would
in NHS Continuing benefit
Healthcare
(from April 2014)

8. What does the announcement mean in practice?
The pilot finishes in October 2012, Government will then make a
decision on the future of personal health budgets based on the results of
the pilots. Subject to the evaluation this will mean that:
• Clinical Commissioning Groups will be able to introduce personal
health budgets on a voluntary basis to anyone who would benefit
from them.
• after April 2014 everyone who is eligible for NHS CHC will be able
to ask for one,
• by April 2014, all Clinical Commissioning Groups will need to have
the capacity and capability to deliver personal health budgets,
• NHS CHC teams will need to understand personal health budgets
and how they sit within the NHS Continuing Healthcare pathway
and be able deliver them

9. Valuable learning from Pilots:
• Financial issues such as how to set budgets and freeing
up funding from existing block contracts, sustainability;
• Scope of service areas that could be included, and
conditions for which it is most appropriate;
• Cultural barriers: personal health budgets will involve a
significant shift of power towards giving real power and
choices to patients;
• The staff training and development needed to ensure staff
have the necessary new skills;
• Building the market to ensure diversity of provision and
real choice;
• Information, support and advice is key

10. The PHB pilot workstreams – getting ready for rollout:
Leadership and ownership: Nurturing and building leadership and ownership of
personal health budgets amongst people who can influence their roll out and
people that they will affect
Communication: Creating and communicating a compelling vision for personal
health budgets and helping people understand what they are
Practical tools: Helping the NHS system understand what it needs to do to
prepare for introducing personal health budgets by developing best practice
tools and learning with sites, in areas such as budgets setting, information
advice and brokerage, and integration of health and social care budgets
Policy: Ensuring that other government policies help make personal health
budgets work through liaison and partnerships with other policy areas.
Workforce: making sure that the right level of skills and understanding of
personal health budgets are developed among the relevant workforce
Providers: Help to ensure that the provider market has an understanding of the
agenda and can start to prepare itself.

11. Conclusion: personal health budgets
• A lot of enthusiasm for personal health budgets and
personalisation more generally
• Still a long way to go – this will take time, and there are
many risks and challenges to overcome
• But great potential to :
- Use existing money more efficiently
- Join up services around the individual
- Help people manage their health better
- Reduce hospital admissions
For more information, visit our Learning Network website
www.dh.gov.uk/personalhealthbudgets
or email the team at personalhealthbudgets@dh.gsi.gov.uk