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“2020health is an important and thoughtful contributor to the health debate”

Dr Sarah Wollaston MP, Chairman, Health Select Committee


OnMedica Patients spend money better than GPs, report suggests

Pilots of personal health budgets show that giving patients control of spending decisions for their own care benefits them and saves the NHS money.

The think tank 2020health analysed results from pilots of personal health budgets published last year as well as at data stemming directly from the pilot areas and came out strongly in support of personal budgets for mental health patients and those requiring continuing care. The authors also said it should in future be rolled out for arthritic patients, for haemodialysis transport and falls prevention.

The report entitled ‘Personal Health Budgets – a revolution in personalisation’, describes how patients make decisions normally made by a GP; what could happen to traditional services and asks whether NHS money should be spent on non-traditional equipment and activities.

Some of the items purchased with personal health budgets by people living with long-term conditions included archery for muscle training for an MS sufferer, air-conditioning or de-humidifying equipment to help with breathing difficulties, singing lessons, as an alternative to respiratory therapy for a COPD patient, and personal assistants.

But results from the 2009-2012 personal health budget trial show that personal health budgets had increased most users’ (70%) sense of what could be achieved in terms of outcomes and lifestyle.

Jon Paxman, main author of the report said “We heard about Nikki who has Still’s disease, an aggressive form of arthritis. A flare-up can immobilise an individual, leaving them bed-ridden for days, even weeks. Social services drew Nikki’s doctor’s attention to the personal health budget scheme and the outcomes have been incredible.”

Nikki’s says, since the PHBs have come into force “I haven’t been in hospital for 15 months. My flare-ups that were lasting for weeks on end… have been cut down to two or three weeks now at home. Having a personal health budget has given me a life…one that I can take control of and actually enjoy.”

Nikki’s GP says “I don’t see Nikki very much. She used to be a very frequent visitor, or I’d see her at home, or we’d be on the telephone an awful lot. I have to say, looking at the results, it’s been the perfect solution. We’ve broken a pattern of frequent admissions, to Nikki enjoying a very long spell of very good health.”

Savings were also made in hospital transport, with patients taking wheelchair accessible taxis in place of conventional ambulance transport, and more generally from declines in primary secondary care admissions. The Department of Health claim that if half of the people eligible for NHS Continuing Healthcare chose to take the offer of a budget, it could save the NHS around £90 million.

Julia Manning, chief executive of 2020health said: “Our report shows how essential it is that the NHS involves patients in the planning of their own care. Only the patient themselves will be able to fully understand what works for them. It is absurd that patients are still not being treated as an essential member of a team through traditional NHS services. The PHB encourages a dialogue between GPs and patients where each share their expertise and a conclusion is reached.

“PHBs treat a person as a whole – allowing them to meet their social, mental and physical needs through one budget. All of these factors are fundamental to good health and without which good health cannot be achieved. This is something we have known for years, but PHBs are finally a way of making integration and whole person care a reality for patients. ”

The government announced the roll out of their personal health budgets (PHBs) programme earlier this year, where an amount of NHS money is given to an individual to help them manage their healthcare and wellbeing needs, instead of having to settle for a package from their GP or council.