The Government has proposed to extend the ‘right’ to have a personal health budget to people with ongoing mental health needs, learning disabilities and autism, as well as those leaving the army.
The number of personal health budgets has been rising year on year since they launched in 2014, with nearly 23,000 people receiving one in the first nine months of 2017/18.
The Government has been promoting the scheme heavily, with workshops and roadshows, and its new consultation is now proposing to expand the ‘right to have’ such a budget to a host of new groups.
But the spending of budgets on luxury items including games consoles and summerhouses, as revealed by Pulse, has caused some controversy around the scheme.
Currently, only individuals in receipt of NHS continuing healthcare, and in the case of children and young people, continuing care, have the right to have a personal health budget – although CCGs can offer personal health budgets to other groups if appropriate.
The DHSC claims that personal health budgets have reduced the cost of healthcare packages by 17% since they launched.
In response, it is now looking into how personal health budgets and personal budgets in social care can be joined together into a single integrated personal budget, wrapped around the individual’s health, social care, and in the case of children, educational needs.
A £1m pilot programme, spanning Gloucestershire, Lincolnshire and Nottingham, was announced by health secretary Jeremy Hunt last month.
The Department of Health and Social Care said: ‘Given the success of the policy thus far, we are proposing to extend individuals’ “right to have” personal health budgets to other groups that we believe could benefit.’
These groups include:
- People with ongoing social care needs, who also make regular and ongoing use of relevant NHS services.
- People eligible for Section 117 aftercare services, and people of all ages with ongoing mental health needs who make regular and ongoing use of community based NHS mental health services.
- People leaving the Armed Forces, who are eligible for ongoing NHS services.
- People with a learning disability, autism or both, who are eligible for ongoing NHS care.
- People who access wheelchair services whose posture and mobility needs impact their wider health and social care needs.
The Department of Health said: ‘A person with an integrated personal budget will have all their health and social care needs considered during one, single assessment, will have a bespoke, single personalised care and support plan, and potentially one integrated budget that meets their needs.
‘The overall aim of the integrated personal budget is to enable the person and their carers to exercise greater choice and control over how their whole needs are met, whilst preventing them needing multiple assessments and managing separate budgets.’
But GP leaders warn that the evidence does not show that personal health budgets directly result in better clinical outcomes for patients.
A BMA spokesperson said: ‘Whilst supportive of patients having more control over their care, the BMA is concerned that NHS funds, which are already stretched to the limit, are being spent on non-traditional treatments and non-NHS services that may not be clinically effective, which the health service can ill afford.
‘There is also the potential for inequity for patients, with those in receipt of personal health budgets being able to access treatments that others may not. Until these issues can be resolved satisfactorily, the BMA will remain unconvinced of the benefit of personal health budgets.’
The spokesperson added that the personal health budget initiative opens up many questions about equity and fairness, and about good use of public funding.
They said: ‘Patients with personal health budgets will arguably be able to access treatments and assistance that other patients with similar difficulties may not. Money traditionally kept within the NHS system to pay for services will be moving into the private sector.’
Patients holding a personal health budget can use their allocated funding to pay for any goods or services, not limited simply to the NHS, that have been agreed with their local NHS team as being worthwhile in helping them achieve their agreed health goals.
Despite fears over funding and calls from NICE chief executive Sir Andrew Dillon to further evaluate the scheme before rolling it out more widely, NHS chiefs have stated their aim to have over 100,000 patients on personal health budgets by 2010.
NHS England announced two years ago that it was aiming to increase the number of patients in receipt of personal health budgets by 2,000% over the next five years.