Implementing Personal

Health Budgets

NHS Southern Derbyshire Clinical Commissioning Group

 Where do personal health budgets
come from?
1970s People with a disability wanted greater:
Choice, Control and Independence
1990s Various social care legislation
Now Care Act, Childrens & Families Act, SEND Reforms
Evidence of success- personal budgets in social care
2009- 2012 PHBs trialed in NHS
From October 2014 NHS legislation for PHBs available to people
accessing continuing health care
From April 2015 NHS legislation for PHBs available to eligible people
with a Long Term Health Condition
Currently just over 4000 PHBs in place nationally
Linked to recommendations made in Stephen Budds report and
transforming care for people with LDs, PHBs for those people will
scale up from 2016

NHS Southern Derbyshire Clinical Commissioning Group

 NHS: A duty to involve
There are two specific legal duties that the NHS
must respond to:

Must promote the involvement of patients and

carers in decisions that relate to their treatment or
care e.g. care planning, personal budgets, shared
decision making, self management.

Must ensure public involvement and consultation

in commissioning processes and decisions

NHS Southern Derbyshire Clinical Commissioning Group

Legal duties: NHS Continuing Healthcare
Rights and personal health budgets
The National Health Service Commissioning Board and Clinical
Commissioning Groups (Responsibilities and Standing Rules)
(Amendment) Regulations 2013 sets out CCGs legal duties
including:

Duty to consider any request for a personal health budget;

Duty to inform people eligible of their right to ask for a personal

health budget;

Duty to provide information, advice and support in relation to

personal health budgets

NHS Southern Derbyshire Clinical Commissioning Group

 Personalisation

NHS Southern Derbyshire Clinical Commissioning Group

 Why is the NHS implementing personal
health budgets?

People want:
More say over their care and support
Choice
High quality

Doing nothing is not an option!

Personal health budgets uses existing
NHS money, not new money

NHS Southern Derbyshire Clinical Commissioning Group

Why is the NHS implementing personal
health budgets?
Continued:
Efficiency will not be enough, we need
to unlock the power of people and
communities;
People must be active partners in their
own care and support better for the
system, but also better for people;
The NHS can no longer adopt a
paternalistic approach to healthcare;

NHS Southern Derbyshire Clinical Commissioning Group

 Person Centred Care
Workforce development and adopting a step wise
rise approach in strengthening the ability and
confidence of staff across the health and social care
sector is important.

This will mean all concerned have a shared

understanding of what it is to be person centred, and
to begin to understand the benefits to care delivered
in a self-directed support manner.

NHS Southern Derbyshire Clinical Commissioning Group

 Personalisation
What does it mean?
Ensuring we work with the person to make sure we
are meeting their specific needs"
"To meet the needs of the individuals in ways that
are best for them and for their wellbeing"
"For the people we support to engage in meaningful
relationships and activities"
"Ensuring that the people we support are listened to
and have a choice in their everyday lives"
"Putting people at the centre of their support."

NHS Southern Derbyshire Clinical Commissioning Group

 Person Centred Care
Give people confidence in person centred care and
to better understand how resilience works and
create the landscape for peer support.

The development to be able to introduce the

conversation about personalisation and increasing
self-efficacy and resilience moving to how would
they do things differently

Moving to personal health budgets if suitable and

starting to equip staff to support PCC care plans and
a better understanding of the voluntary sector.

NHS Southern Derbyshire Clinical Commissioning Group

 Personal health budgets (PHBs): the
opportunities
Helping people manage their health better

Part of meeting the identified need, is enabling a

person to do things differently and then a monetary
solution can be agreed.

Using existing money more efficiently

Joining up services around the individual

Reducing hospital admissions

NHS Southern Derbyshire Clinical Commissioning Group

 What is a PHB?
A personal health budget is a mechanism to support
a persons identified health and wellbeing needs, the
application of which is planned and agreed between
the individual, their representative or, in the case of
children, their families or carers and the local NHS
team.

It is not new money but it is money that would

normally have been spent by the NHS on a
persons care, being spent more flexibly
to meet their identified needs.

NHS Southern Derbyshire Clinical Commissioning Group

NHS Southern Derbyshire Clinical Commissioning Group
 SDCCGs Local Offer
NHS England expect all CCGs to have a Local Offer in
place during 2015/16.
Based on evidence available from pilot sites, SDCCGs
local offer will focus on individuals accessing MH and /
or LD services. Where evidence exists to support
significant improvements to peoples health and
wellbeing.
Outside of this offer individuals with a LTC[s] who are
eligible and can benefit can access a PHB.
Take up is difficult to predict, evidence suggests take
up will be slow initially SDCCG predict 25 PHBs in
2015/16

NHS Southern Derbyshire Clinical Commissioning Group

 Distinctive features
The person knows how much money they have upfront .
The person chooses the outcomes to be achieved, in
agreement with their health professionals.
The person is enabled to create their own support plan,
with whatever support they may want.
The person freely chooses the way in which their budget
is held and managed.
Whichever option is chosen to hold and manage the
money, the person is able to spend it flexibly, to achieve
their planned outcomes.

NHS Southern Derbyshire Clinical Commissioning Group

The Forward View into Action: NHS Planning
Guidance

* To give patients more direct control, we expect CCGs to lead a

major expansion in 2015/16 in the offer and delivery of personal
health budgets to people, where evidence indicates they could
benefit.
As part of this, by April 2016, we expect that personal health
budgets or integrated personal budgets across health and social
care should be an option for people with learning disabilities, in
line with the Sir Stephen Bubbs review.
To improve the lives of children with special educational
needs, CCGs will need to continue to work alongside local
authorities and schools on the implementation of integrated
education, health and care plans, and the offer of personal
budgets.
CCGs should engage widely and fully with their local
communities and patients, including with their local
Healthwatch, and include clear goals on expanding personal
health
NHSbudgets
Southernwithin their published
Derbyshire local Joint Health
Clinical Commissioning Groupand
What can a budget be spent on?
Traditional services do not always fit with the way a person
lives their life, this flexibility can support the person to start
making their own decisions, live independently, move away
from institutional care, in some cases return to work and
significantly improve their and their carer, friends and
familys quality of life and wellbeing.

Anything agreed in a care plan which will meet health and

wellbeing objectives
Equipment
Personal care
Therapies
Complimentary therapies
Supportive technology (eg computers, ipads, kindles)

NHS Southern Derbyshire Clinical Commissioning Group

 PHB EMarketplace
NHS Share Business Services is working on an
exciting new development to provide a PHB
eMarketplace.
Offers an online portal for PHB patients to order
goods and services from their PHB allocation.
Will provide a professional front-end to the
service and will simplify the buying and
engagement experience for PHB recipients
whilst improving visibility of spend for CCGs.
Goes live Summer 2015.

NHS Southern Derbyshire Clinical Commissioning Group

 What a Personal Health Budget
cant be spent on
Primary medical services provided by GPs
Vaccination or immunisation
Screening
The national child measurement programme
NHS Health Checks
Urgent or emergency treatment services
Surgical procedures
NHS charges, such as prescription or dental charges
Alcohol or tobacco;
Gambling;
To repay a debt (with the exception of debts relating
to services specified in the care plan).
Anything illegal or unlawful.

Guidance on Direct Payments for Healthcare: Understanding the Regulations, March

2014

NHS Southern Derbyshire Clinical Commissioning Group

Once the level of need has been agreed
there are 4 stages to a personal health
budget

NHS Southern Derbyshire Clinical Commissioning Group

Different ways of delivering a personal
health budget
Notional
individual
budget

More direct control to

Personal Real budget

individuals
Care & held on the
Support individuals
behalf
plans
Direct payment
cash held by
patient

NHS Southern Derbyshire Clinical Commissioning Group

 Next Steps Locally

How could my practice or I get involved?

What would we want to overhear people saying about

PHBs locally?

What do you think the risks are regarding PHBs

NHS Southern Derbyshire Clinical Commissioning Group

Contact Details

Name: Joanne Goodison

Title: Commissioning Manager
Personal Health Budgets
Tel: 01332 868727 M 07795 887851
Email: joanne.goodison@southernderbyshireccg.nhs.uk
Web: www.southernderbyshireccg.nhs.uk

NHS Southern Derbyshire Clinical Commissioning Group