Personal Budgets, Personal Health Budgets and Integrated Personal Commissioning - what does this all mean and what are the opportunities?

1. Personal Budgets, Personal Health Budgets
and Integrated Personal Commissioning–
what does this all mean and what are the
opportunities?
Lilian Beasant- Integrated Personal Commissioning Team

2. Integrated Personal Commissioning
• Jointly managed by Herts Valleys and East & North Herts Clinical
Commissioning Groups and Hertfordshire County Council
• Sponsored by NHS England until March 2018 - combining resources across
health, social care and beyond
• Putting patients and carers at the centre of decision making by supporting
people to become active participants in their communities
• IPC can help to reduce unplanned and emergency care
• Supports the whole health system to be more sustainable.
• All Age Personalisation Steering Group

3. An integrated, whole population approach to personalised
care
3

4. Five key shifts

5. What is a Personal Health Budget
NHS England definition
A personal health budget (PHB) is an amount of money to support the
identified healthcare and wellbeing needs of an individual, which is planned
and agreed between the individual, or their representative, and the local
clinical commissioning group (CCG). It isn’t new money, but a different way
of spending health funding to meet the needs of a individual.
Personal health budgets are one way to give people with long term health
conditions and disabilities more choice and control over the money spent on
meeting their health and wellbeing needs.
https://www.england.nhs.uk/personal-health-budgets

6. Characteristics of a PHB
The person with a personal health budget (or their representative) should:
1. Be central in developing their personalised care and support plan and agree who is
involved
2. Be able to agree the health and wellbeing outcomes* they want to achieve, together
with relevant health, education and social care professionals
3. Get an upfront indication of how much money they have available for healthcare
and support
4. Have enough money in the budget to meet the health and wellbeing needs and
outcomes* agreed in the personalised care and support plan
5. Have the option to manage the money as a direct payment, a notional budget, a third
party budget or a mix of these approaches
6. Be able to use the money to meet their outcomes in ways and at times that make
sense to them, as agreed in their personalised care and support plan.
*And learning outcomes for children and young people with education, health and care
plans.

7. Personal Health Budgets and Personal Budgets
Adults and Children eligible for social care funding have the right to have a Personal
Budget.
As of October 2014 Adults eligible for NHS Continuing Healthcare and Children eligible
for Continuing Care have the right to have a Personal Health Budget.
People have a choice as to how they receive their PHB or PB:
• Notional Budget
• Direct Payment
• Third Party Management
Why do people choose to have a PB or PHB?
• To have more choice, control and flexibility
• To employ personal assistants directly
• Consistency of staff
• Maintain support through transition

8. Types of PHBs

9. Personal Health Budgets and Personal Budgets

10. What’s Missing?
How can voluntary sector and
community organisations support?

11. Support to develop a PHB
• Information, Advice and Guidance
(IAG)
• Signposting and triage
• Support Planning
• Specialist “Brokerage” Sourcing

12. Support to maintain a PHB
• Recruiting Carers and Personal Assistants
• Payroll
• Managed account services

13. Services, resources and activities for budget
holders and self funders to buy
Training for Carers
and Personal
Assistants
Technology
Personal Training
Singing lessons
Drumming lessons
Carer/ PA support
Hydrotherapy
Zoo memberships
Counselling
Club/ group
memberships

14. What next?
• Scope services you currently offer that could be
bought by budget holders.
• Identify unit costs.
• Scope new services/ resources that could be offered.
• Build a plan for sustainability.
• Marketing
• Prepare to receive funds directly from budget
holders.

15. IPC Herts Valley
Case study – Age UK
“She put me at ease. She spoke to me on the
same level. I wasn't talked down to and she
treated me as though I was a person, rather
than an object. That happens to me quite a lot
these days – people speak to you like you don't
know anything or don’t know your own mind,
but I can still function on an intellectual level.
That’s what was different: she made me feel
like a person and she listened to what I was
going to say and I found that very, very
encouraging. It made think more about what I
needed and wanted to do.” Client

16. The key features of the Age UK PICP model

17. Improved Welbeing
•Wellbeing has been improved by:
Helping older people to become
aware of their own needs and
fostering agency – empowering
clients to make purposeful choices
and to be in control
Enabling independence and
wellbeing through practical support
Reducing isolation and raising
ambition by motivating clients to re-
engage with interests and become
more socially connected
Providing an ‘extra arm’ of support
for older people

18. < than 4% of referrals: Home and
garden services, other VCS I&A,
advocacy and support services, Private
Sector personal home care services,
Age UK volunteering, Home aids and
advice (non-local authority support),
Personal alarms and telehealth,
Dementia specific groups, Energy
advice, Unwanted calls and mail
blocking services, Home safety checks,
Podiatry)
Snap-shot of where clients are ’signposted’ or
supported to help them achieve their goals

19. NHS
< than 1% of NHS referrals:
• NHS Helpline for advice on health costs
• Speech and Language Therapy
• Community Continence Team
• Integrated Care Team
• NHS Choices
• NHS Prescription Services
• Smoking cessation service

20. Other (unspecified)

21. Di’s Diamonds Redbridge Barking and
Havering
• One of the emerging needs for people with
multiple long term conditions has been to reduce
loneliness and isolation cause by poor health and
diminished social circles of support.
• Di Diamonds
• This was established by two volunteers in Havering who set up a programme of activities and outings
for older people including coffee mornings, knitting group, bowling, Irish Dancing, theatre and
museum outings, daytrips, restaurant outings, etc. This has grown in the last 3-4 years and it
currently has a reach of 400 older people mainly living in Havering.
• Programme of activities includes:
• Two Coffee mornings every month one at the Bravo Café in Romford and one at the Queen’s Theatre
in Hornchuch
• A knitting group at the Queen’s Theatre
• One Bowling group in Romford on the first Tuesday of every month
• Irish Dancing in Forest Gate on the first Thursday on the month.
• Several outing to theatre, concerts, museums, gardens, walks each month.