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We are serious about this and have mandated
a commitment to ensure 300,000 people benefit from
personalised health and care by 2018/19, including
40,000 people with a personal health budget and for
50-100,000 people to have one by 2021. The initial up-
take figures are promising with nearly 16,000 people
now with personal health budgets, which is more than
double the figures from the previous year.
The Personalised Health and Care Framework
helps local healthcare professionals to deliver this more
personalised approach within their communities.
Building on the previous Emerging Framework
published in May 2016 and working closely with the Local
Government Association and others, this framework is
an update for commissioners and providers about how
they can use Integrated Personal Commissioning and
Personal Health Budgets locally. It is a `go-to' resource
which will include details about the Integrated Personal
Commissioning Operating Model and a Finance and
Commissioning Handbook. It also offers practical ways
and case studies in which the NHS, local government,
providers and the voluntary and community sector
can now all work together, as well as emphasising the
importance of co-production.
So what changes should clinical commissioning
groups (CCGs) expect to see once Integrated
Personal Commissioning and Personal Health
Budgets are implemented on a larger scale?
Integrated Personal Commissioning is a
practical delivery model that enables the whole NHS
system to join up and personalise its approach. Recent
results from a local programme in Stockton-on-Tees
demonstrate just how successful this operating model
can be. The impact of this programme resulted in a
significant reduction in unplanned hospital admissions
for frail, older people; as well as a 35% reduction in
delayed transfers of care from hospital and a 41%
reduction in A&E attendances in the final quarter.
Personal Health Budgets, which are one
mechanism for delivering Integrated Personal
Commissioning, have already demonstrated that
they can also play an important part in addressing
the financial challenges facing the NHS, yet without
sacrificing individual health outcomes and in most cases
exceeding them.
In Warrington, some people experiencing End
of Life care are now using Personal Health Budgets to
support their choice of the place that they would prefer
to die in, with 83% of people able to die in a place of
their choosing, against the average of 26% being able
to do this. This also resulted in some significant cost
savings, as one week's worth of traditional service
funding could now provide six weeks' worth of services
now commissioned through a Personal Health Budget.
Finally in Nottinghamshire where a brother and
sister who have very complex health conditions and
were in receipt of a commissioned transport package
for their day centre and respite journeys. They now use
their Personal Health Budget to lease an adapted vehicle
which has resulted in approximately 19,000 saving in
transport costs a staggering result and importantly
the siblings now have more choice and control as they
now have flexibility to use the vehicle any time they
need and also have their highly trained carers with them
at all times.
And these examples are just the beginning.
They highlight the potential opportunity for
real changes that can be implemented on a much wider
scale throughout the country which address the critical
pressures facing our health service whilst improving
individual health outcomes by offering people more
real choice and control.
by James Sanderson
James Sanderson is the Director of Personalisation and
Choice at NHS England, working within the Strategy
and Innovation Directorate to oversee the personal
health budgets programme, the delivery of the
Integrated Personal Commissioning (IPC) Programme,
and developing and implementing new models of
delivering patient choice. You can follow James on
Listen to James Sanderson here:
Haris chooses his
own carers and ar-
ranges a schedule
that works for him
Martin can keep
active on his bike
which has been
adapted to suit his
condition