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08.08.18

We need to take personal health budgets seriously

Source: NHE July/August 2018

Don Redding, director of policy at National Voices, and its communications & engagement officer Laura Bell, look at the voluntary sector’s role in helping to deliver personal health budgets (PHBs).

“As hard as it is to watch my [adult] child deteriorate…  I wouldn’t change a single thing. Having a PHB has helped me keep us together as a family for longer and with a better quality of life.”

That’s one woman’s experience of holding a PHB on behalf of her adult daughter. More such stories can be found by following the hashtag #myPHBstory on social media. PHBs are a form of personalised care that sees an individual control an amount of money to support their own health and wellbeing needs.

Recently, there has been a spike of interest in PHBs from policymakers. Back in March, then health and social care secretary Jeremy Hunt acknowledged that PHBs were key to enabling people to have control over their healthcare and opened a consultation on extending the categories of people who may be given the right to have them. NHS England also has targets to give up to 100,000 people a PHB by 2021.

PHBs empower people to have choice and control over their healthcare and related support, prioritising the needs and wants that are most important to them. However, for the potential of PHBs to be realised, collaborative working with the voluntary sector is key. 

Engaging the voluntary sector

The voluntary sector has expertise, insight and knowledge of local communities that cannot be duplicated by statutory bodies: organisations are grounded in the very same communities as the people they serve. 

When CCGs and the voluntary sector work together, healthcare has the potential to be transformational for individuals. 

Challenges

Collaborative working is not always easy, though. National Voices, NAVCA and Volunteering Matters spent two years working with health commissioners and voluntary organisations across England exploring the delivery of PHBs as part of the Integrated Personalised Commissioning programme. 

Whilst there were some fantastic examples of partnership working that had enabled individuals to have their healthcare transformed by PHBs, we also heard of frustrating experiences for both commissioners and voluntary organisations when trying to work together.

All CCGs are required to make the offer of a PHB to relevant groups of people known publicly. However, voluntary organisations often found it difficult to locate a CCG’s local PHB offer, know who best to contact in the CCG, or how best to communicate with them. On their side, many CCGs felt that VCSE groups and organisations were not always good at understanding their potential roles in supporting the roll-out of PHBs, and how this could help them deliver their own mission.

Overcoming challenges

Throughout the programme, we found ways of overcoming some of these challenges. Building personal relationships based on mutual understanding between individuals in CCGs and voluntary organisations is essential to successful partnerships. 

For the voluntary sector, spotlighting real-life examples of change for people who have benefitted from a PHB and evidencing good practice through measurable indicators helps to engage CCGs.

For the system, an openness to the diversity, knowledge and flexibility of the voluntary sector is key. There is also potential to explore the role of sustainability and transformation partnerships (STPs) in joining up different organisations, promoting person-centred approaches, and getting PHBs on agendas across different areas of the system.

Additionally, it is worth exploring which local bodies can help to broker better joined-up practice between commissioners and community organisations. That might be a council for voluntary services, or there may be a new role for the local Healthwatch.

Personalisation is no easy task, and it needs support and buy-in on all sides: from health commissioners, statutory bodies, voluntary and community organisations, and people using health services. 

Whilst they’re not right for everyone, PHBs offer promising outcomes that prioritise the wants and needs of the individual. They empower people, enable them to take control of their care and be active citizens in their communities. Voluntary organisations have a pivotal role to play if the potential of PHBs is to be realised.

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