Many of you will be familiar with personal budgets for social care, but from April, 56,000 people with highly complex, long-term health needs who are eligible for NHS continuing healthcare will have the right
to ask for their care to be delivered as a personal health budget and the NHS will have to respond. And come 2015, commissioners are expected to be ready to offer a personal health budget to anyone with a long-term condition who could benefit from one.
This could transform the lives of people such as Stephen, who in 2008 sustained a spinal injury which left him paralysed from the shoulders down. After nearly a year in hospital, Stephen returned home to his partner and children but found that the care commissioned by his primary care trust was inflexible and not tailored to his needs.
It wasn’t until Stephen participated in a personal health budget pilot in Nottinghamshire in 2010 that he was able to gain control of his care. He used his budget to hire his own team of carers, including two gardeners who can help him spend time outside with his young daughter. As well as allowing him to be a father again, being in the garden stops him getting ill. His personal health budget does not cost any more than the original care agency but offers far greater value for money.
Stephen is among several personal health budget holders who feature in Delivering Personal Health Budgets, a book that draws on my seven years of experience working to develop and deliver the concept in the UK and US. Personal health budgets present an opportunity for the NHS to broaden its focus from delivering healthcare to supporting people with health needs to live their lives to the fullest extent possible. This comes when the need for cost-effective approaches to the management of long-term conditions is pressing.
The biggest challenge for commissioners is to unlock money from existing contracts. NHS providers will have to change the way they do things or lose out to new entrants. Budget holders will demand greater flexibility and a broader, more preventive range of care services than the NHS currently buys. For clinicians, it will mean a willingness to explore new approaches to meeting long-term health needs.
I wrote Delivering Personal Health Budgets as a guide to implementation with the aim that many more people who depend on the NHS could experience the same life-changing impact from a personal health budget as Stephen and his family.