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Further evaluation of personal health budgets needed, says NICE chief

NICE should evaluate the personal health budget scheme before it is rolled out more widely, its chief executive has said.

Speaking at the NICE annual conference today, Sir Andrew Dillon said he ‘did not know’ whether personal budgets were ‘the most effective use of resources’ and that they should be evaluated and tested ‘like any initiative that takes place’.

The comments come after a Pulse investigation recently revealed that personal health budgets were being used to fund non-evidence based treatments such as holidays abroad or pedalo boating.

As it stands, NICE is not evaluating the personal health budgets following ‘a decision that’s been made by those with political stewardship for the health and social care system’, Sir Andrew said.

He told the conference: ‘Whether or not me getting a budget if I develop a long-term disabling condition like rheumatoid arthritis… so I can influence my care is the most effective way of using resources, I really don’t know.

‘It should be evaluated. It should be tested like any of the initiatives that take place.’

In the light of the Pulse investigation, the BMA has called for a review of the scheme, which was initially piloted and rolled out among patients with severe physical or mental disabilities but is now available to any patient suffering a long-term health condition.

Sir Andrew made his comments under questioning from former GP and broadcaster Dr Phil Hammond who strongly advocated that the scheme go through an evaluation.

Dr Hammond said that in his view, ‘rolling out personalised budgets for health and social care’ was ‘potentially… the most destructive innovation for empowering patients’ and that ‘clearly it needs to be properly evaluated [by] NICE’.

Sir Andrew’s response also highlighted that it was ‘hugely important that patients have influence about what it is we get’.

Since April this year, adults and children on NHS continuing healthcare have a right to a personal health budget, but CCGs are free to offer them to other people with long-term conditions if they think they will benefit from it.

It is the Government’s long-term aim to introduce a right to a personal health budget for anyone who would benefit from it.

NHS England insists the budgets offer patients greater control over their care at the same time as saving the NHS money. 

Readers' comments (7)

  • I've always thought PHBs are a Trojan Horse policy, leading the way to cash limits on individual entitlements to NHS and social care.

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  • Vinci Ho

    (1)The idea of personal health budget was mentioned in a forward written by John Redwood(Tory MP) in Oliver Letwin's book- Priviatising the world: a study of international privatisation in theory and in practice , way back in 1988.
    (2) Tories know they are not to be trusted to deliver health services by the public(a well known but unpublicised truth) , the only way to gain 'popularity' is monetary measures, hence bribing its way right up to that. The overall cost of bribery is small compared with seriously injecting real , solid money to save NHS(for all their irresponsible promises like seven days NHS) . At the same time , at least voters can be pleased by giving them money to 'look after' their health: win-win situation , favourite term used by economists.
    (3) As Michael J Sandel said in his book , What money can't buy: the moral limits of markets,these economic/financial incentives will crowd out norms which ,in this case, are the core virtues of NHS. The 'new' theory and message that health actually can be 'bought' with money crowd out the norms of providing people the proper health education.
    Like everything else in the eyes of economists , health problems can be solved by economic , monetary measures.
    (4)Professor Martin McKee wrote about personal health budget in the Introduction of the book--NHS for sale: Myths , Lies & Deception (2015), Jacky Davis, John Lister , David Wrighley

    ''After all ? Who could argue with the idea that individuals are best placed to know what health services they need, and indeed this may be true for some people with multiple complex problems . However , as experiences with a wide range of financial services and utilities would have predicted and the Dutch experience with personal health budgets has shown , they also provide numerous opportunities for unscrupulous companies to exploit the vulnerable.'

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  • The positive aspect is that there still seems to be a lot of money rattling in the NHS pot to dish out for votes. After all, it's the best system (con) in the world.

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  • Phb s are dogmatic lunacy that will clearly lead to waste and fragmentation
    Typical so called independent NHSE has to be forced into doing the obvious ..as 'independent' as NHSE!

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  • Practice Nurse -
    My daughter aged 30 was accepted for these payments as a person with ME since age 16. She roughly has 2-3 unpredictable "normal" days a week so impossible to have a routine to work. The organisation is just as much a nightmare as the Student Loan Co.. Until these agencies get their act together or are properly monitored themselves, they seem incompetent and leave the vulnerable at risk of no money. Since trying to liase and keep the agency informed of her change of area and address, they deny and have no record of such communication so they just withhold her payments. If she did not have my support, they appear to have no qualms leaving her to starve. The anxiety of dealing with them means jumping through the hoops they create, compromises her health even further.
    Of course more letters from her GP involves further £25 "private" charges to prove her poor health which as a parent, I see as an NHS issue.

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  • I'm very sorry for you 'Practice Nurse' but ME is a psychosomatic problem not an organic disorder. as such she should absolutely not be able to access a ' personal health budget'
    I understand your dislike of having to pay a private charge for a health report, I think you would really dislike paying for mine. 'This patient has no organic pathology but describes tiredness and weakness. I am unable to offer a medical opinion as to the validity of her claim as there is no evidence of disease'

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  • Couldn't agree more
    There is no such thing as ME
    It was re-named CFS about 20 years ago and is entirely psychogenic
    And yes, any report requested will cost you £100 to pay for my expertise, time and secretarial time
    You would not expect free accountancy, legal work or food at Tescos!

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