Government announces plans for extension of personal health budgets


The government wants to increase the number of people who use personal health budgets (PHBs) to choose their own health and social care support from 40,000 to as many as 200,000 over the next five years.

It has approved extending legal rights to PHBs to disabled people eligible for funding from NHS wheelchair services, and those eligible for aftercare services under section 117 of the Mental Health Act.

But it also signalled that these rights would eventually be extended to other groups, including people with ongoing social care needs who also make regular and continuing use of particular NHS services; people leaving the armed services who are eligible for ongoing NHS services; and autistic people and those with learning difficulties who are eligible for ongoing NHS care.

PHBs give individuals a pot of money to spend on their health and wellbeing needs, in agreement with a healthcare professional.

Many disabled campaigners have supported the expansion of PHBs, arguing that they could help deliver independent living for disabled people, while others have raised concerns that they could be part of a creeping privatisation of the NHS, and that they are based on the same “failing” model used with social care personal budgets.

Currently, only adults receiving NHS Continuing Healthcare, and children and young people who receive continuing care, have the right to a PHB.

But the Department of Health and Social Care (DHSC, pictured) and NHS England have now published their response to a consultation, which ended last June, on extending that right to other groups and the possibility of extending that to include a right to have the PHB managed through direct payments.

The government response says people “value being involved in the planning of their care, being able to make choices and personalise their support so it best meets their needs”.

And it says the evidence suggests that those who can do that “are more satisfied with their care, have better outcomes, and are able to explore more innovative approaches to meet their needs”.

The consultation also asked for views on whether the government should bring together PHBs and social care personal budgets – and educational needs in the case of disabled children and young people – into an integrated personal budget.

The consultation results suggested widespread support for a further expansion of PHBs, with 87 per cent (330 of 379 people) of those who answered the question saying they believed that autistic people and those with learning difficulties who are eligible for ongoing NHS care should have a legal right to a PHB or an integrated personal budget.

And more than 90 per cent supported extending the right to a PHB or integrated personal budget to those using NHS wheelchair services, with 87 per cent saying this group should also have a right to receive that budget via direct payments, if appropriate.

DHSC and NHS England said their ambition was “to move towards joined up and integrated provision across health and social care” through a “comprehensive model of integrated, personalised care” and with PHBs and integrated personal budgets “a key component” of this plan.

These plans are set out in the new NHS Long Term Plan.

The government and NHS England said they believed that more than 200,000 people would have a PHB by 2023-24, including many from the five groups they consulted on last year.

Although the government is only taking forward legislation on those using wheelchair services and mental health aftercare, it says it will “continue to further explore both the other groups we consulted on, and additional groups who we believe could also benefit from having a right to have a personal health budget”.

Some additional groups that could benefit and were mentioned by those taking part in the consultation included people with dementia, people receiving end-of-life care, and those receiving community equipment.

NHS England said it would continue to work with clinical commissioning groups to “design and test” the use of PHBs for other groups of people and service areas.

Care minister Caroline Dinenage said: “I’ve seen first-hand how personal health budgets can give people a new lease of life, granting them the ability to enjoy their lives to the full.

“These budgets help to join up health and social care services, improving people’s experiences and outcomes whilst ensuring value for money for taxpayers.

“We are therefore extending access so many more people can benefit, a key part of our NHS Long Term Plan which will see personalised care become the norm for millions more.”

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