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 one 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:
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:
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 centered 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. Read more about care and support plans.
A personal health budget can be managed in 3 ways, or a combination of these.
A person will:
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.
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.
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 this service and should be available in the next few months. Read more about wheelchair services.
Since December 2019 people who are eligible for Section 117 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. Read more about the process for mental health after care.
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:
NHS Kernow will monitor its delivery of PHB’s 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 PHB’s and will use this information to improve the delivery and roll-out of PHB’s in the future.