Getting personal: personal budgets in the NHS

Don Redding argues that personal budgets may change how NHS professionals work with clients.

Personal budgets are controversial for many professionals: people’s choices for buying support for their care and treatment may appear unconventional and ‘non-evidence based’; and there may be concern about money ‘leaving the NHS’ in a kind of ‘micro’ privatisation.
However, National Voices, the coalition of national health and social care charities working for person-centred care, supports the use of personal budgets as a route to more personalised care and support.
Together with charities with experience in supporting personal budgets in social care we published Personal Budgets as an Integral Form of NHS Care in December. This paper argues that, designed properly, these budgets are consistent with NHS values, and effective in improving outcomes for individuals – and their carers.
Personal budgets are evidence based. A 2015 survey of users in adult social care a large majority experiencing improvements to their quality of life; independence and control; self-esteem; and mental and physical health.
For the NHS, a thorough evaluation of initial pilots – including for people with neurological conditions and stroke – found ‘a significant positive impact on care-related quality of life and psychological well-being’. This discussion paper, published by the Department of Health in 2012, can be found here
Personal budgets are spreading through a national Integrated Personalised Commissioning Programme. This new NHS planning guidance implies there will be a ‘major expansion’ of personal budgets; and implementation in local areas already advanced in integrated care, such as the ‘pioneers’. The Care Act 2014 says adults who receive social care should have a single integrated personal budget across health and care.
For physiotherapists and other professionals, the main implication of personal budgets will be the change of culture they are designed to achieve. The budgets should be underpinned by personalised care and support planning that helps people – especially those with long term or fluctuating conditions – focus on their own self-determined goals.
Professionals will increasingly need to work in partnership with clients towards achieving these personalised outcomes, incorporating clinical treatment into the pursuit of independence, wellbeing and quality of life. For many allied health professionals this will be a welcome affirmation of what they already try to provide, and an opportunity to draw their clinical colleagues down the same path to personalisation. 
Don Redding is director of policy, National Voices.

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