Personal health budgets

Last year the Government pledged its commitment to creating a more personalised and responsive NHS by nominating 70 sites across England as provisional pilots for personal health budgets. Of these, twenty have been selected for an in-depth study as part of a wider evaluation exploring the potential of personal health budgets to benefit different groups of people. The study will be conducted by a partnership between existing research teams at three institutions, led by the personal social services research unit (PSSRU) at the University of Kent.

There is growing evidence that personal health budgets help improve care received by chronically ill patients.  The idea is simple: allow frail seniors and persons with disabilities to manage a flexible budget and decide for themselves what mix of services and technologies will best serve their needs.

According to independent evaluations, while empowering patients and their families, personal health budget initiatives may also: 

• Improve access and quality of care

• Ensure fewer unmet service needs

• Improve patient satisfaction and quality of life

• Reduce visits to hospital emergency departments

• Reduce other health care costs

The NHS has begun new pilots to test personal health budgets for persons with chronic conditions. For people with chronic conditions, the idea is to give individual patients greater control over the services they receive and the providers from which they receive services.

The pilots from 2009 to 2012 will test three different approaches:

1. A budget held by a Primary Care Trust on behalf of the patient

2. A budget managed on the person’s behalf by a third party such as a charity or user trust

3. A cash payment to a patient that is then managed by them directly

A report from the NHS Confederation explores the potential of NHS funding within personal budgets and notes; “Developing responsive and individual packages of care will drive up the quality of care provided to people who have a range of needs.  Before piloting gets fully underway, we need to consider the commissioning, funding, and staffing and service design issues associated with developing personal health budgets. The NHS Confederation has found a consensus that urgent and emergency care and elective procedures, already delivered through tariff, should not be part of personal health budget calculations. Some operational issues still need careful consideration, for example whether NHS money could be spent on non cost-effective treatments such as high-cost medication or alternative therapies.”

Combine the issues on personal budgets, with the promised freedom of choice, and the logical conclusion could be that all of us should have a ‘personal health budget’ and decide how to use it either within the NHS or private sector, to pay for insurance or even go abroad for treatment. Politicians all claim they want the NHS to be more accountable, what better way of controlling quality that to give everyone free choice of how the money is spent – so poorly performing NHS hospitals would have to improve or go out of business. 

Health insurance: Hot Topic: January 2010