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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)

  • Anonymous | Other healthcare professional | 01 September 2015 9:08pm

    I hope you realize "estimated" cost saving is just that - an estimate. We know too often a scheme, such as 7 day GP opening claims to have saved local AED attendance and saved X million pounds. Yet we do not see CCGs and hospitals in millions of underspend. Why?

    Because people re-adjusts their behaviour and hence their use of health system changes. This is not just for patients but for health care workers also.

    So I'm afraid your talk is just a pie in the sky. I wish the world was as simple as yours. "keep up to date" mate ;)

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  • @OHP 9:11pm
    You actually tried to present yourself as intelligent by posting a link of studies on PubMed as latest research about Nintendo Wii.
    Have you actually gone through those studies? Most of them have some technical issues that will limit their external applicability or justify the use of NHS (taxpayers' money and at the risk of cutting off other services)money. Most of those studies have really small sample size.
    Secondly, the money used for this lunacy is not new money. It is part of NHS budget. There is no reason to spend NHS money on stupid health programs with questionable health and economic benefits.

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  • 8:56am

    Yes I did read the studies and many of them found that Wii Fit had comparable outcomes to conventional physiotherapy. So in individual cases (where a patient may not be able to get to NHS physiotherapy services due to debility, disabilities, mental health issues or transport issues) then it may be more useful for the patient to have some motivating exercise tool at home.

    As far as the NHS budget goes, it doesn't just provide pills and chemo - it offers all kinds of other services provided by occupational therapists, physiotherapists, mental health services and psychological services.

    Therefore if there are ways to provide services to patients that are individualised to the patient's needs (eg. perhaps they are too ill, disabled etc. to attend group events) and if these have good outcomes for patients (i.e. improved wellbeing) and good outcomes for the NHS (ie. lower usage of more expensive hospital services) than I really don't see what the issue is.

    Apart from that as usual on pulse we see many doctor-centred posts that assume the only thing that matters is what doctors can provide (pills, chemo and radiotherapy).

    There are other ways to promote and maintain good health for patients - it's time to consider them.

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  • Is the real problem of Personal Health Budgets the threat to doctor's clinical monopoly to determine what treatment is, and is not available to patients?

    http://safe-medicine.blogspot.co.uk/2015/09/personal-health-budgets.html

    Personal Health Budgets facilitate Patient Choice, and Health Freedom, which means that patients might want to access non-pharmaceutical treatment.

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  • Gosh, is it hard to understand the simple economics?

    All of above will only work if patients cannot access any health care once their budget runs out. Currently they can use their budget how they like, and when it runs out they'll start accessing health care system as rest of the population does. This erodes the funds for everything else. GPs are opposng this not because we want monopoly (quite the opposite given we are NOT paid per activity but rather a block contract)

    Come on guys, try and look a bit beyond your agenda and try and understand how things work a little before making comments like "Is the real problem of Personal Health Budgets the threat to doctor's clinical monopoly"

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  • @ Steve Scrutton, 12:05
    You are not really a health care professional are you?

    If patients want to waste their own money on homeopathy and other woo that is fine. Just don't ask the NHS to foot the bill via PHP while denying others the option of proven treatments for cancer on cost grounds.

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  • As commented elsewhere PHB saves money - interesting how may people give this a political rather than practical spin! Most packages of care are for people with complex life long healthcare needs I hope to never experience. Being able to manage their needs and services directly is often more cost effective improves the situation. BUT it does threaten the professions control over anything with the word 'health' in it. Perhaps that's actually what is behind the outrage.... the coverage is silly season at its best.

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  • Some extreme right wing views on display here.Some health professionals appear to have lost their sense of perspective and need to refer to their professional codes of conduct!

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  • some quite surreal comments in this string.
    There is a clear divide between science and belief here.
    In a social healthcare system there is no limit to what each individual can consume, whereas in a capped social care system each individual can only consume more than the minimum if they have personal funds.
    Thus personal health payments are a ridiculous crossover between two separate systems.
    Hopefully they will disappear soon

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