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The waiting game

Personal health budgets likely to only benefit 'assertive' patients, says expert

Personal health budgets due to be introduced this year in the NHS are unlikely to improve outcomes as they tend to only benefit ‘assertive’ patients, says a reseacher.

Professor Peter Beresford, professor of social policy at Brunel University, told a meeting today that personal health budgets were not a ‘magic bullet’ and they would not be an effective driver for the changes the NHS requires.

In fact the researcher - who has researched widely the personal budgets scheme developed in social care - said as personal health budgets were based on the same model they were ‘unlikely to be any more successful’.

Speaking at the Westminster Health Forum Event on Thursday he said: ‘[The people] benefitting from personal health budgets, are disproportionately people receiving direct payments, who are doing so because they are receiving proportionally more money, and they tend to be, tend to be, the more confident, supported and assertive people.

He added: ‘The claims that the evaluation of the personal budget show that this model resulted in better outcomes, misrepresent what the evaluation found, which was actually the opposite, and we will be showing that in a forthcoming journal article.’

He added that his research showed that in social care a more fundamental change its workforce and organisational structure was needed, rather than personal budgets.

He said: ‘Personal budgets are not providing a magic bullet, as was unrealistically hoped for.’

From April 2014, personal health budgets must be offered to the 56,000 patients currently receiving NHS Continuing Healthcare, and patients with a long-term condition are due to get a ‘fundamental right’ to demand one from their CCG from September.

Personal health budgets are intended to empower patients with complex, long-term care needs to make decisions about the care and support they wish to receive, but pilots of the scheme to give patients either a ‘notional’ budget or NHS cash to spend, have been controversial with patients were using their budget to buy theatre tickets, ready meals and complementary therapies.

But Dr Alison Austin, lead on personalisation and control at NHS England said that the process would be closely monitored.

She said: ‘On an individual level the care plan would be very clear, essentially what it is is: what your needs and outcomes are, how much money it is, what you’re using for it, risks and that sort of thing, and then there’s a review process to check. So it is reviewed.’

Dr Austin states that the scheme needs to focus on ‘outcomes’ and that patients, as experts in their own care needs and should be free to take the risks and rewards of managing a budget.

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Readers' comments (5)

  • "patients, as experts in their own care needs and should be free to take the risks and rewards of managing a budget."

    What, exactly, is the 'risk' for a patient that wastes their budget?

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  • Granted there are patients who take their health seriously and become expert in managing their condition.

    But there are also many who are just not interested. Smokers who had full explanations of dangers, obese patients who thinks they are just 'curvy', diabetics who thinks they should be able to eat what ever they like because they feel ok, just to name a few. They are hardly an expert in health care and I doubt their personal health budget would be used wisely to maximize the effect.

    In the mean time NHS care continues to be cut......

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  • I wouldn't have a problem if the picking list was limited to medical therapies. Provision of things like theatre tickets is really not what the system was designed for.

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  • CAn't wait to get mine. Get a few beers and curries. Perfect destress from working in the NHS panto.

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  • The chairman of NICE Prof Haslam is urging patients to be more assertive with their GPs. Wide scale culture is needed.

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