1. IPC & PHB expansion March 2016

2. 1 www.england.nhs.uk Purpose This slide pack provides an update on the recently developed work programme to significantly expand the offer of personal health budgets, and rapidly progress the work required to deliver a replicable Integrated Personal Commissioning (IPC) framework for wider adoption. Some of this work is still in the formative stages; and More detailed analysis is currently being conducted to sharpen up the forecasts on expected PHB numbers, but policy based predictions have been provided in this pack.

3. 2 www.england.nhs.uk Personal health budgets: where are we now

4. 3 www.england.nhs.uk PHBs/IPC: Modelling of expected position at March 2017 Through the interventions and actions detailed within this pack we are aiming to achieve the following position by March 2017:  We expect 12-16k people will be receiving a PHB which is between a c. 280 and 372% increase, and in line with what is needed to deliver on the Mandate commitment;  IPC being fully implemented in eight sites with a further 10-12 sites established on STP footprints;  A full replicable IPC blueprint published, including a comprehensive PHB toolkit;  By October 2016 we will have developed a detailed strategy and delivery plan including clarity on eligibility and trajectories to ensure we are able to meet the Mandate expectation; and  We will have provided information and resources to STP Footprints as part of the ‘how to’ guides.

5. 4 www.england.nhs.uk Personal health budget trajectories Note: Delivering at the bottom of the range of what we expect by 16-17 would put us on course to deliver the lower end of the Mandate following growth comparisons from social care over a similar period. Delivering at the top end of what we expect to deliver would require us to exceed comparable growth in social care and would put us on course to deliver the top end of the Mandate. These projections reflect our policy ambitions and confidence in delivery rather than detailed analysis of all eligible cohorts and will be refined once this work is complete

6. 5 www.england.nhs.uk Client groups who will have a PHB in 2016/17

7. 6 www.england.nhs.uk Increasing the take up of PHBs / IPC Narrative and tools We will clarify the offer and develop the infrastructure and tools to scale up PHBs/IPC Increase the depth We will increase the depth of the PHB offer by further developing those areas already targeted Increase the breadth We will increase the breadth of the PHB offer by developing new areas to target Driving demand We will work to develop demand for the agenda from the patient, commissioner and provider perspectives. Develop levers and enablers We will develop levers and enablers to support and maintain growth. Narrative & tools Increase depth Increase breadth Drive demand Levers & enablers

8. 7 www.england.nhs.uk 1. Narrative and tools We will clarify the offer and develop the infrastructure and tools to scale up PHBs/IPC. In order to deliver this we will:  Conclude our ‘Developing the Local Offer’ training programme by October 2016 to offer support all CCGs in England to operationalise their PHB offer;  Publish the emerging framework for IPC based on the first year of delivery by May 2016;  Publish a comprehensive and refreshed PHB toolkit by October 2016 to provide a clear and simplified operating model;  Introduce 5 Collaborative Development Groups (CDGs), made up of representatives from each IPC site by April 2016, in order to rapidly coproduce the core components of the IPC model; and  Publish initial blueprints for the core IPC components by October 2016 to support wider replication of the model and pave the way for national availability.

9. 8 www.england.nhs.uk 2. Increase the depth We will increase the depth of the PHB offer by further developing those areas already targeted. In order to deliver this we will:  By October 2016, develop a detailed strategy, including revised forecasts, and a targeted delivery plan to ensure we are able to meet the mandate commitment of 50-100K by 2020;  Design and deliver a rapid rollout programme to support CCGs to make PHBs a mainstream delivery option for NHS CHC and CC for children by July 2016;  Provide specialised advice to the Transforming Care Programme by September 2016 to enable local partnerships to offer PHBs and Integrated PHBs as part of a new service model for people with a learning disability;  Support the development of Sustainability and Transformation Plans that reflect our ambition for PHB expansion in line with the Mandate through provision of ‘how to’ guides and dedicated on the ground support as needed by STP Footprints; and  We will deliver a leadership programme to raise the profile of PHBs with senior partners.

10. 9 www.england.nhs.uk 3. Increase the breadth We will increase the breadth of the PHB offer by developing new areas to target. I n order to deliver this we will:  Work to develop the PHB ‘brand’ through diversification into other key target areas, whilst maintaining the core DNA of the model to ensure the concept is protected;  Work towards an announcement on 18 May, of the intended replacement of the current wheelchair voucher scheme with Personal Wheelchair Budgets, alongside an incremental implementation plan, and rapid test bed programme;  Explore the feasibility and delivery options for the extension of PHBs in end of life care;  Deliver maternity pioneer programme to test PMCBs, with the announcement of the selected sites planned for May; and  Deliver a shared learning event in March 17 to bring together the learning from all these programmes and explore new opportunities for expansion.

11. 10 www.england.nhs.uk 4. Driving demand We will work to develop demand for the agenda from the patient, commissioner and provider perspectives. In order to deliver this we will:  Deliver a development programme for people with lived experience to strengthen understanding of and demand for PHB / IPC by September 2016;  Establish regional VCSE networks to strengthen the role of the sector in supporting PHB delivery from September 2016;  Run roundtable events with Richmond Group CEOs and DRUK partners to support discussion around a social movement for health personalisation;  Deliver a PHB conference on the 18 May to provide renewed energy for the agenda and launch our expansion plans; and  Deliver a targeted communications strategy, working with corporate communications to raise the profile and improve public understanding of the agenda.

12. 11 www.england.nhs.uk 5. Develop levers and enablers We will develop levers and enablers to support and maintain growth. In order to deliver this we will:  Support the development of STPs to ensure they reflect expectations on PHB / IPC delivery;  Monitor and act upon CCG IAF results, whilst working to develop additional measures;  Establish an assurance process to monitor progress with PHB / IPC in line with the Mandate;  Establish a Minimum Dataset of activity and outcomes metrics for IPC for use by all sites by June 2016; and  Introduce new MoUs for all IPC sites to include expectations for PHB / IPB delivery at the top end of the Mandate and within a quicker timeframe by May 2016.