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Gold, incentives and meh

Revealed: NHS funding splashed on holidays, games consoles and summer houses

Exclusive Millions of pounds of NHS funding have been spent on luxury goods such as summer houses, holidays and pedalo boats, under a scheme to give patients ‘personal health budgets’.

A Pulse investigation found that the scheme to give ‘patients more control over their care’ has been used to buy many unevidenced treatments at the expense of long-established services, which have been defunded.

Information obtained under a Freedom of Information Act shows that CCGs in England predict spend of over £120m this year for 4,800 patients on the personal health budgets scheme.

CCGs reported the following services were bought by patients on the scheme:

  • NHS Nene CCG and NHS Corby CCG gave patient funds to have a holiday to rest and reconnect with family, an iRobot, and the construction of a summer house;
  • NHS Kernow CCG spent £2,080 on a patient’s aromatherapy, £248 on horse riding lessons and even spent money for a patient to hire a pedalo;
  • NHS Stoke CCG spent money on a Wii Fit games console for a patient, and £1,000 on a patient’s weekly music lessons.

Since October last year, all eligible patients have had the right to hold a personal health budget, which allows them to spend NHS cash as they wish. NHS England’s Five Year Forward View has called for a ‘major expansion’ of the scheme.

But experts have been scathing, as NHS England estimates it needs at least £20bn in efficiency savings to stand still by 2020. 

Pulse has learnt that personal health budgets are beginning to destabilise existing services, with one mental health service having to close its doors due to its funding being ploughed into the scheme.

Dr Richard Vautrey, deputy chair of the GPC, says personal health budgets can have a ‘very big impact on existing services’.

He said: ‘Quite often they are working within  limited margins and so loss of even a small amount of their income can jeopardise a whole service – so this can have serious implications for large numbers of people just based on the whims of a small number.’

Professor Nick Watson, professor of health and wellbeing at the University of Glasgow, said the scheme was ‘consumerist’.

He said: ‘I think that we are going forward on poor evidence and there is a clear ideological drive behind it.’

But an NHS England spokesperson said: ‘Personal health budgets are designed to meet identified health needs in ways that give patients more control over the care and support they receive. The spending must be agreed between the individual and the NHS, meet the patients individual health needs and achieve the desired outcomes.’

The policy has been plagued with controversy from its inception. Initial pilots for the scheme, launched in 2009, gave patients an upfront pot of money – either as a direct payment or a ‘notional’ budget held by the CCG or other independent party – for them to spend on services as they chose.

An independent evaluation of the personal budget pilots – led by the Personal Social Services Research Unit at the University of Kent – found there was a significant improvement in the quality of life and psychological wellbeing of the patients and a reduction in hospital costs.

However, it also found patients used significantly more non-NHS services as result of using the personal budgets, and that money was spent on theatre tickets and ready meals.

Readers' comments (41)

  • "Examples of ‘alternative’ PHB use in context are:

    people suffering from depression paid for leisure activities to reduce social isolation

    some patients with diabetes improved wellbeing by using the money for a Wii fit or personal trainer

    a patient with cancer bought a wig of their choice

    an iRobot vacuum cleaner was bought by a disabled person

    archery lessons for muscle training for an MS Sufferer

    air-conditioning or de-humidifying equipment – to help with breathing difficulties

    singing lessons, as an alternative to respiratory therapy – for a COPD patient

    However the statistics show that the vast majority of funds (80-90%) are spent on carers, PAs and nurses."

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  • Una Coales. Retired NHS GP.

    Thank you Pulse for exposing another daft scheme concocted by government and delivered ineptly by CCGs. Perhaps some accountability is in order to the individuals who approved an iRobot, whatever that is?

    Mainstream news has picked up this abuse of NHS funds and run with it. Dr Monah and I will be expressing our views on this topic tonight on C5 news at 6:30 pm. Needless to say I shall be EXTREMELY VOCAL against this socialist hairbrained scheme of spending other people's hardearned taxes and NI contributions on a lucky 4,800 who have received not basic but LUXURY items to improve their wellbeing. Oh if we could all afford an iRobot or wii fit console so we could sit on the sofa and play games all day...

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  • Go on Una, at least we have a spokesperson in you !

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  • Or another way to look at this would be to count our lucky stars that we're not in a position where we can't clean our own houses (and therefore need assistance either from a care provider (expensive, conventionally funded provision) or from an irobot (cheap alternative).

    I'm not sure why anyone would expect disabled and sick patients live in dirty homes - is poor hygiene good for their health and wellbeing?

    Is a Wii fit at £200 more LUXURY than hours of expensive physiotherapy and associated costs?

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  • Una Coales. Retired NHS GP.

    If a disabled person cannot clean their home, feed or clothe themselves, then the state provides social services and care homes. Game consoles have no place in the delivery of healthcare. Common sense must prevail else there will be nothing left of the NHS to care for the elderly and disabled.

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  • I think some of the less informed and narrow visioned thinks NHS runs for free.

    Well I've got news for you - it doesn't! NHSE wants "efficiency" saving in the region of 20 billion by 2020. Why? Because the country does not have enough money to support it's health care!

    So those who thinks Wii and theater tickets as part of "holistic care" ask yourselves this - would you be happy if I turned around and told you we can't treat your cancer with the latest drug because we spent it on holistic care. Do you think I'm exaggerating? Think again, this has been the case for many years in the NHS.

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  • @6:30 -

    As described, the money isn't coming out of your drugs budget - there are other budgets for occupational therapy, mental health services and physiotherapy.

    And (if you read the article) the scheme has SAVED hospital costs compared to the costs of what would have been given as the conventional treatment and has seen an improvement in QOL and wellbeing.

    A Wii Fit might be a cheaper therapeutic tool for someone than lots of sessions with an expensive physiotherapist and it also might be more accessible to someone with disabilities.

    Theatre tickets might be more emotionally uplifting for someone with mental health issues, than a group therapy session. It's about what works for the patient and what saves the NHS money.

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  • If you keep up to date with the latest research, you'll find that the Wii fit is in fact being used as a tool to deliver healthcare...

    http://www.ncbi.nlm.nih.gov/pubmed/?term=wii+fit

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  • @OHP 9.11pm
    Keeping 'up-to-date' with the latest research is akin to scratching a bears' bottom - whilst fun to begin with, it all turns out to be crud in the long run, and most likely to be dangerous for your health.

    As for wii fit being a 'tool to deliver healthcare', I can't help but think that if you are physically capable of working out on a wii fit, you are probably capable of following a keep fit instructor/physio/exercise sheet- all more cost effective ways of rehab/physical training.

    IMHO, PHB is definitely a waste of resources in resourced starved NHS.

    DGPP (3yrs)

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  • Phb is lunacy
    In a grossly underfunded nhs to waste resources on any non evidence based intervention is a disgrace as it reduces the effectiveness of the overall spend
    Available evidence for this is patchy and controversial
    It is a recipe for waste chaos and red tape on the grand scale
    A totally deranged idea from cloud cuckoo land or worse another secretive duplicitous Trojan horse for the privatisation agenda which is strongly opposed by the vast majority of the electorate
    The very idea that this madness is to be extended while cancer drugs are being withheld is another national disgrace due to doh and nhse

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