29th June 2015 Written by Scott Parker (Commercial manager, North Somerset community partnership)

Image: Personal health budgets: let’s tackle the myths.An increasing number of people are using personal health budgets but not all healthcare professionals are convinced. Scott Parker addresses the main concerns.

Intuitively, most people involved with healthcare get the basic concept of personal health budgets. Offering people who receive health and care support the opportunity to shape the services they receive can only be a good thing, right? I am one of those who say “yes”. Yes, those receiving care, along with their families, should have a bigger part to play when planning for their care and support.

Yes, supporting people to achieve their personal goals helps improve health.

Yes, supporting people to support themselves is the right thing to do.

But there are healthcare professionals who aren’t sure whether personal health budgets are the right thing, even if they do agree with the aims of ensuring choice, flexibility and control. Having spent the last 12 months working in a team to develop services to support people choosing personal health budgets in the Bristol area, I can say there are four myths, misconceptions and approaches we need to address.

You can spend the money on whatever you’d like

The first one is actually a misunderstanding and quite simply dealt with. While speaking with healthcare professionals I regularly get asked if people can simply take a personal health budget and spend the money on whatever they want? Well, the answer is no, every person receiving a personal health budget has a personal care plan and money is only spent on services and support which help achieve the personal goals and health outcomes. And, as you might expect, the money cannot be spent on alcohol, gambling or anything illegal.

The quality of service will decrease

Next is the question of ensuring and assuring quality. Quite rightly, we should always strive to provide the best possible outcome for patients and delivering high quality care is a core component of this. A question I am often asked is that if a personal budget holder can buy services from wherever they like or have personal assistants conducting tasks a nurse currently does, how will quality be maintained? This well-motivated and informed question normally comes from practitioners who are constantly striving to achieve the highest standard of care they can and they don’t want anything to compromise patient care.

I believe that personal health budgets can actually improve quality but we do need safeguards. By ensuring that personal care plans are clearly articulating risk, how this will be addressed and by who, I think we are starting from a good place. It is then up to the local commissioners and personal health budget support services to implement this effectively. We must always ensure staff are trained and competent to do what we are asking them to do. Appropriate case management needs to be put in place and of course we need to check we are delivering the health outcomes described in the personal care plan. There is an ever increasing number people using personal health budgets and within this, an ever increasing body of evidence that outcomes improve and quality does not fall. However, it is going to take time until everyone is won over.

Personal health budgets reduce costs

Some people believe that personal health budgets are in fact all about reducing cost or even a way of privatising the NHS by the back door. In some ways this is a difficult one to answer. For personal health budgets to be a success there needs to be a wider variety of service and support options for people to choose from and for this to happen, I do believe we need a larger number of service providers. Personally I would like to see local and community driven services developing, really maximising the existing assets of people and the community, but that is for another blog. Back to the main point. In many ways I think personal health budgets can be a more effective way of spending the health pound; people who are in control of their health and achieving their personal goals are less likely to be reliant on the health service. In the long run this can be one of the ways we can make the money go further. I do believe that with budgets not keeping up with demand, we need to be pragmatic and embrace new ways of working … we will never have enough doctors and nurses.

Personal health budgets will change the NHS culture

In my mind the final point we need to address is possibly the most challenging, that of culture. Within the NHS there are a lot of dedicated professionals, drawing on years of training and experience to make an effective and credible clinical judgement. In my opinion this is one of the things which makes our health service one of the best in the world. We can sometimes stand accused of confusing our own opinion with fact. For the wider personalisation agenda to succeed we need to remember that people know their lives better than the professional does. We can do this by changing the conversations we have, recognising the individual has a lot to offer and by having a genuinely authentic relationship with our patients.

The National Skills Academy for Health has partnered with Partner2Care and Skills for Health to develop an e-learning course to help professionals acquire the knowledge and thought processes they need to effectively discuss this as an option with patients. Click here to find out more