'Get real' over personal budgets, government told

The roll-out of personal budgets will fail unless the government 'gets real' and addresses practical issues about patients uptake and wastage the scheme may cause, NHS leaders have warned.

Personal health budgets will be offered to 50,000 patients with long-term conditions such as asthma
Personal health budgets will be offered to 50,000 patients with long-term conditions such as asthma

Earlier this week, health secretary Andrew Lansley announced personal health budgets will be offered to 50,000 patients in England by 2014 to choose and direct the care they receive.

He said the scheme would ‘personalise the NHS and provide more integrated high quality care across health and social care’.

A report from the NHS Confederation's Mental Health Network agreed that 'the time has come' for personal budgets, but warned that issues surrounding the scheme’s adoption by patients and clinicians may threaten its success.

The NHS Confederation's Network director Steve Shrubb, said: 'The power given to patients by personal budgets will not stay in their hands unless there is a shared view on how they will work, what support is available and what the evidence base is.

'Simply building the structures and expecting people to come and take up personal budgets will not be enough. This kind of thinking belongs to an undistinguished line of policy initiatives that have promised so much and delivered so little.'

He added that the government and the health and social care system must examine these practical and cultural issues ‘before we can hope to successfully role out personal health budgets.'

The report, Personal Health Budgets: Countdown to Roll-out, gathered opinions from service users, clinicians and social care leaders.

It found many potential users intend to move away from drug interventions and hospital visits and opt for ‘de-medicalised’ treatment such as alternative and complementary medicine if handed a personal budget.

Many of these choices do not have a clinical evidence base, it said, which local leaders and clinicians found unacceptable.

Local social care leaders also expressed concern that few people would choose personal budgets, forcing the system to run parallel support for those who do and do not take up the budgets.

The Mental Health Network issued five questions it believes the government and NHS must answer if the system is to work:

  1. Has the national evaluation generated evidence that personal health budgets improve outcomes, experience or costs?
  2. Does the roll-out establish guidance for a significant expansion of the brokerage and advocacy systems?
  3. Has a viable solution been found for how to release funds to finance personal health budgets at scale?
  4. Have sufficient preparations been made to integrate personal health budgets in the NHS with personal budgets for social care?
  5. Does the plan to roll out personal health budgets contain sufficient levers to drive take-up?

The Network concluded that all involved parties need to tackle these issues or else personal budgets risk being 'one in a line of policies that promise to increase personalised care but deliver little as the barriers to effective change are either ignored or underestimated'.

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