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

Dr Sarah Wollaston MP, Chairman, Health Select Committee

 
 

BBC Radio Kent, Sky News, Channel Five News ‘NHS allows patients to splash cash on holidays, summer houses and Wii Fits’

The Government offered the right to have a personal health budget - which provide patients with their own budget to spend on care they feel would benefit them - to any patient on NHS Continuing Healthcare nationally from 2014, and it was rolled out to any patient with a long-term condition in April 2015. Further evaluations are due to be published in March 2016.

The GP magazine Pulse have undertaken FOI requests and heard back from 33 Clinical Commissioning Groups on what PHB monies have been spent on.

2020HEALTH’S TOP MESSAGES

The Pulse report smears people who have received a PHB. 2020health produced a balanced report in 2013 "Personal Health Budgets: a revolution in personalisation" highlighting the benefits and concerns around PHBs.

• We spoke to NHS PHB leads who implored cynics to examine expenditure of state money by the outcome, not by the thing bought. Results have shown that from the 2009-2012 personal health budget trial there was a majority view (70%) among users that the PHB had increased their sense of what could be achieved in terms of outcomes and lifestyle.

• PHBs allow people to
- identify what is important to them in their health and wellbeing,
- consider what will be of the most help
- take more control and responsibility for their health
- make efficiencies and savings in their care costs

• Pulse, a magazine for GPs, has run successive biased articles against personal health budgets, which in our opinion reflects some GPs unwillingness to allow patients to make decisions about their care.

OUR TAKE – CLINICAL AND POLITICAL

1. We know that medical treatments have limited efficacy and all have side effects. Evidence shows that at most, 60% of people comply with their prescribed medication, and experts claim that 90% of drugs only work in 30-50% of people[1] (hence the drive for pharmacogenetics). Pills are not enough.

2. The growth in Social Prescribing mirrors the PHB ethos that people often need non-medical treatment to meet their health and wellbeing needs.

3. To ridicule patients through their choice of treatment is arrogant and regressive; some GPs have been superb at encouraging patients to take control and seen the benefits to both their health and in reduced expenditure.

4. Examples of ‘alternative’ PHB use:
• people suffering from depression are paying for leisure activities to reduce social isolation
• some patients with diabetes have improved wellbeing by using the money for a Wii fit or personal trainer
• a patient with cancer has bought a wig of their choice
• an irobot vacuum cleaner for a disabled person

However the statistics show that the vast majority of funds (80-90%) are spent on carers, PAs and nurses.

Julia Manning, Chief Executive, 2020health said: “Our last report showed how essential and effective it is when the NHS involves patients in the planning of their own care. Only the patient themselves know why improving their health matters to them – which is why we need to start thinking of ourselves as PARTICIPATIENTS. It is absurd that patients are still not being treated as an essential partner in their health – and some professionals need to stop being so paternalistic. The PHB encourages a dialogue between GPs and patients where each share their expertise, motivation and a shared plan is shaped together.”

“PHBs treat a person as a whole – allowing them to consider their social, mental and physical needs through one budget. PHBs are finally a way of making integration and whole person care a reality for people.”


SUPPORTING REFERENCES

“PHBs are important tools for recovery. They give greater control to individuals and allow them to go beyond statutory services…the very approach embeds the three core components of recovery: hope, control and opportunity.” Royal College of Psychiatrists, December 2012

Northampton, one of the in-depth (pilot) sites specialising in mental health, collated the following list of measurable health outcomes in April 2012. These are outcomes that their MH patients with PHBs were at the time either making progress towards or achieving:

• An increase in their independence and their confidence, they feel much more in control
• An increase in social interaction and social activities of many different types
• Improvement in mood, reduction of stress/anxiety and a change in behaviour, which has enabled increased contact with family, children and friends
• Being able to give much more support to others
• An increased understanding of their condition/ disease and how and why it is impacting on their life
• Improvements in general physical health including losing weight, learning to swim, attending a gym regularly
• A reduction or ceasing of self-harming
• Studying for new qualifications, gaining or returning to employment both paid and unpaid/voluntary work; development of a back to work plan
• Reduction of, or stopping, medication
• Managing crisis/exacerbations of condition/ disease, recognising triggers and managing
symptoms, keeping safe
• Reduction in the need for and use of acute and primary care services

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[1] http://news.bbc.co.uk/1/hi/health/3299945.stm

 

BBC Radio Kent Drivetime 1.9.15

Julia also spoke on Sky News 1.30pm about Personal Health Budgets