A key part of this is developing how personalised care is offered to individuals.

This will be delivered, based on what matters to them and their individual strengths, needs and preferences. This happens within a system that supports people to stay well for longer and makes the most of the expertise, capacity and potential of people, families and communities in delivering better health and wellbeing outcomes and experiences. This is 1 of the 5 major, practical, changes to the NHS service model in the NHS long term plan. It recognises that personalised care is central to a new service model for the NHS, including:

• working through primary care networks
• people have more options and better support
• appropriate joined-up care at the right time in the optimal care setting

This shift represents a new relationship between people, professionals and the health and care system. It provides a positive change in power and decision making that enables people to feel informed, have a voice, be heard and be connected to each other and their communities.

Personalised care is about looking at the needs of the individual as a whole and working with them to prepare a care plan that suits their personal needs.

There are 6 components to this:

1. Shared decision making.
2. Personalised care and support planning.
3. Enabling choice, including legal rights to choice.
4. Social prescribing and community-based support.*
5. Supported self-management (please contact your GP for further details).*
6. Personal health budgets and integrated personal budgets.

* If you or a family member are or have been a member of the armed forces community (including veterans) you may need advice on issues including:

• health
• education
• housing
• training
• jobs

Personal health budgets

A personal health budget (PHB) is an amount of money to support a person’s individual health and wellbeing needs, as agreed between the individual and their local NHS team. The person’s health and wellbeing needs will be set out in a personal centred care and support plan. The plan will be developed by the person together with a health care professional. How the budget will be used to support the health and wellbeing needs will be set out in this plan and agreed by both the person and the local NHS team.

A personal health budget can be managed in 3 ways, or a combination of these.

A PHB and integrated personal budget (IPB) is an amount of money to support a person’s identified health and wellbeing needs, planned and agreed between them and their local CCG. This may lead to integrated personal budgets for those with both health and social care needs. This isn’t new money. It is a different way of spending health funding to meet the care needs of an individual.

Personalised care design principles

A person will:

• get an upfront indication of how much money they have available for healthcare and support
• have enough money in the budget to meet the health and wellbeing needs and outcomes agreed in the personalised care and support plan
• have the option to manage the money as a notional budget, a third-party budget, a direct payment or a mix of these approaches
• 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

PHBs can pay for a wide range of items and services, including therapies and personal care, allowing more choice and control for individuals to manage their own health.

PHB local offer

NHS Kernow has made PHBs the default method of commissioning care for adults who are eligible for NHS continuing healthcare in receipt of care at home since April 2019.

In addition children who are eligible for children’s continuing care have the right to have a PHB. This is fully operational.

Who is offered a PHB?

Since December 2019 wheelchair users have a right to a PHB to obtain their specific wheelchair. A process is being developed in order for people to access PHBs for the wheelchair service and should be available in the next few months.

Since December 2019 people who are eligible for Section 117 mental health aftercare have a right to a PHB. A process is being developed in order for people to access PHBs for this service, and should be available in the next few months.

Previously a small cohort of people who have had 2 or more long term conditions and/or a mental health need, who are also high users of NHS services have successfully used a PHB to access support not available within commissioned services. Following a review of these cases a new cohort of clients is being considered to benefit from a PHB. We are trialling the benefit of health coaching and a PHB. The trial includes people who have complex long term pain, a long term health condition/mental health need and have prescribed opiate dependency. These people have been identified by the complex pain team and their GP and been invited to participate.

In future we will be considering offering PHBs for the following people:

• veterans
• end of life care or fast tracks
• mental health clients
• maternity
• long term conditions
• intense users of services
• any cohort of people where traditional care has not met their needs and are still accessing services that are not adding benefit

NHS Kernow will monitor its delivery of PHBs internally and report to the Governing Body and will also report nationally to NHS England. NHS Kernow also welcomes feedback from people and their families about their experience of PHBs and will use this information to improve the delivery and roll-out of PHBs in the future.

Contact the personalised care team

E-mail: personalhealthbudgets1@nhs.net
Telephone: 01726 627659