The NHS long term plan sets out the vision for the future NHS including a new relationship with patients and communities that supports people to gain greater control of their own care when they need health services.
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 one of the five 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 Kent and Medway's primary care networks
- people having 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 six components to this:
- Shared decision making
- Personalised care and support planning
- Enabling choice, including legal rights to choice
- Social prescribing and community-based support*
- Supported self-management (please contact your GP for further details)
- Personal health budgets and integrated personal budgets.
A personal health budget 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 personalised care and support plan.
The plan will be developed by the person together with health care professionals. It will record how the budget will be used to support the health and wellbeing needs agreed by both the person and the local NHS team.
A personal health budget can be managed in three ways, or a combination of these.
Notional budget
No money changes hands. You find out how much money is available for your assessed needs and together with your NHS team you decide on how to spend that money. They will then arrange the agreed care and support for you.
Third party budget
Provided by an organisation legally independent of both you and the NHS. For example, an independent user trust or a voluntary organisation. They hold the money for you, and also pay for and arrange the care and support agreed in your care plan.
Direct payment for healthcare
You get the money to arrange and pay the for the care and support you and your NHS team agrees you need. You must show what you have spent it on, but you, or your representative, buy and manage services yourself.
A personal health budget and integrated personal budget is an amount of money to support a person’s identified health and wellbeing needs, planned and agreed between them and their local clinical commissioning group. 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 and support planning is essential to making personal health budgets work well. A personalised care and support plan helps people to identify their health and wellbeing goals, together with their local NHS team, and sets out how the budget will be spent to enable them to achieve the agreed outcomes and keep healthy and safe.
The person with a personal health budget (or their representative) should:
- Be central in developing their personalised care and support plan and agree who is involved
- Be able to agree the health and wellbeing outcomes* they want to achieve, together with relevant health, education and social care professionals
- 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 direct payment, a notional budget, a third party budget 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.
*And learning outcomes for children and young people with education, health and care plans.
The NHS wheelchair service offers personal wheelchair budgets to support wheelchair users in Kent and Medway to access a wider choice of wheelchair.
Since 2 December 2019, people who access wheelchair services, whose posture and mobility needs impact their wider health and social care needs, now have a legal right to a personal wheelchair budget.
People that are eligible for Section 117 mental health aftercare have a right to a personal health budget.
If they are assessed as needing care at home, that is jointly funded by the local authority and the NHS Integrated Care Board (ICB), their NHS Assessor and social worker will discuss personal health budgets as part of the personalised care and support planning process.
Personal health budgets for patients whose care at home is not funded by the ICB and the local authority are being developed.
The ICB aims to increase the offer of personalised care in line with the NHS long term plan.
If you or a family member are or have been a member of the armed forces community, you can find support or advice on our local council websites on issues including health, education, housing, training and jobs:
Kent and Medway Integrated Care Board (ICB) will monitor it’s delivery of personal health budgets internally, reporting to the Governing Body and will also report nationally to NHS England and Improvement.
Kent and Medway ICB also welcomes feedback from people and their families about their experience of personal health budgets and will use this information to improve the delivery and roll-out of personal health budgets in the future.
If you have any questions please email kmicb.ageingwell@nhs.net