NHS Midlands and East is a cluster of SHAs comprising NHS East Midlands | NHS East of England | NHS West Midlands Heather Ballard, Personalisation Lead NHS Midlands and East Personalisation Personalised Care Planning Personal Health Budgets – what’s it all about?

Personalisation  No decision about me, without me  On average, people with a long term condition, spend 3 to 4 hours a year with a health professional (out of a total of over 8,700 hours)  A personal approach - film

Personalisation in health – why?  Biggest health challenge includes managing long term conditions  Accounts for:  70% of NHS spend  77% in patient bed days  68% of out patient and accident and emergency appointments  55% of GP appointments  Between 30-50% of patients do not take their prescription in full and UK annual cost of wasted drugs is approx £100M) (DH, 2008)  Health service resources tend to focus on interventions, rather than on prevention and management

Commissioning Framework 2012/13 The SHA Cluster ambitions set out in the commissioning framework are:  1. Eliminating avoidable pressure ulcers  2. Making every contact count  3. Significantly improve quality and safety in Primary Care  4. Ensuring radically strengthened partnership between the NHS and Local Government  5. Create a revolution in patient and customer experience -  The aim here is to stimulate a revolution in patient and customer experience across the NHS Midlands and East, ensuring that sustainable improvements in patient, carer and customer experience are achieved  The 3 Cs  Co-Production  Community Involvement  Customer Satisfaction

Personalisation – a multi faceted approach  Self Care/Self Management  Personalised Care Planning  Raise expectations with service users and carers  Support changed behaviours, attitudes and approaches with all health care workers for all interventions  Influence workforce planners and commissioners  Commission for outcomes which support people with long term conditions

Planning Together

PHB Context PHBs sit within wider context of personalisation Personalised care planning is central to delivering self-directed health & care Person-centred tools & techniques can help us to develop personalised care plans & deliver person-centred services

Personal Health Budgets The aim of a personal health budget is to improve both outcomes and patient satisfaction by giving people more choice and control over the NHS care they receive. Personal health budgets have potential to improve the lives of patients, and their families and carers, by enabling them to choose the care and services which best suit their needs. This includes choosing alternative providers or having greater control over when and where services are delivered.

What can a PHB be used on? Anything where a health outcome can be identified excluding: Emergency or acute services The majority of primary care services (including visits and assessments of GPs) Anything illegal Gambling Debt repayment Tobacco Alcohol

Pilot Sites As at 13 th January 2012 there were 59 pilot sites -18 in the Midlands and East region Twenty of these pilot sites have been selected for an in-depth study, as part of a wider evaluation exploring who will benefit most from personal health budgets and how the NHS can make them work. The number of pilot sites is growing rapidly as the deadline for applying for approval to offer direct payments draws close

The Specific Commitments NHS Operating Framework 2012/13  PCT clusters should prepare for wider roll-out of personal health budgets, following the completion and evaluation of the pilot programme, due to end in October Subject to evaluation, this should include preparation for all patients with NHS continuing care to be offered a personal health budget for relevant aspects of care by April 2014 at the latest. The NHS will need to consider how to deliver personal health budgets locally and include this as part of transition planning.

Integrated Packages of Care  Taking into account the evaluation of current pilots, delivery should particularly focus on the overlaps between health and social care and on integrated packages of care for long term conditions.  Some of the PHB pilots are using personal health budgets as a way of enabling health and social care to work together to develop joint care and support plans and give people a joint budget to pay for their health and social care needs.  And housing needs?.....

Any Questions?  for A Personal Approach   Link to the Personal Health Budget pages of the NHS Midlands and East website - it contains our regional newsletters and the 4 national interim reports. Further information