Guest blog by Rita Brewis, Co-founder of Peoplehub blogs about the launch of the 2020health report ‘Personal Health Budgets: a revolution in personalisation‘. Rita can be contacted on firstname.lastname@example.org
Peoplehub is a personal health budget peer network. Its purpose is to connect, inform and empower people; and to help to influence national and local policy so that personal health budgets stay true to purpose and are implemented effectively.
As a co-founder of peoplehub I was delighted that Alex was invited to explain the difference having a personal health budget has made in his life. People’s voices need to be a core part of helping to constructively change the relationship between the NHS and the people it serves.
Personal health budgets are one way that the NHS can take forward personalisation. Personalisation is about shifting power and creating an improved relationship, with changes for both professionals and people needing help and support.The central focus is improving the dialogue between the individual and the professional to create:
- Greater mutual respect & understanding
- Better quality decision-making
- Better outcomes
This should produce a Personal Plan which is co-signed by the person and professional.Money alone is not sufficient to shift relationships and achieve better outcomes, though it can be an important lever for change. Making personal health budgets work well depends on people making changes in their thinking, feeling and behaviour.
People need to be empowered with good information. Processes need to be transparent. People need to know what the ‘deal’ is and how decisions have been made.
This requires a cultural shift in the NHS and the people it serves.
It was encouraging to hear Norman Lamb identify four shifts he sees as necessary to ensuring personal health budgets work well. These were shifts:
- from Repair to Prevention– avoiding hospital admission and crises through tailored support which allows an individual with a long term health condition to better manage their care;
- from an Exclusive system to a much more Inclusive approach where families, neighbours and communities work in collaboration with providers; and there is a focus on wellbeing not just on care delivered;
- from a Fragmented system where people fall through gaps to Integrated care shaped around the needs and strengths of each person;
- from Paternalistic care where the individual is a passive recipient to a Partnership approach where the person is an active participant and their views are valued and their experience welcomed, alongside the experience and knowledge of health professionals, through shared decision-making.
Personal health budgets can be transformative when they are implemented well. Active participation by local people with long term health conditions and disabilities in creating local policy and processes will help to ensure they work well from the start. Similarly on-going feedback from people with lived experience of holding a personal health budget is crucial to their success.
The development of local peer networks is recognised in the 2020 report as an essential resource for the personal health budget programme- helping to shape and develop local frameworks and creating a space where issues can be raised and debated alongside key decision makers. Peer networks create an opportunity to hear what’s working well and what could be done differently as personal health budgets are rolled out more widely.
“Personal health budgets allow people to move from a world where others know best, to one where their input is valued above all others but not in isolation from others.”
“It is a way to allow the individual to be at the heart of the planning process, identifying with key health professionals the things that really matter to them and which allow them to lead a safe and fulfilling life” (Personal health budgets peer network members, 2012).