1. Working together for a healthier Nottingham The National Personal Health Budget Pilot Programme Gemma Newbery NHS Personal Health Budget Project Manager

2. Working together for a healthier Nottingham What is a Personal Health Budget? (PHB) A Personal Health Budget (PHB) is an amount of money that is allocated to a patient. The patient has choice and control over how this money is spent to meet their own personal and clinical outcomes.

3. Working together for a healthier Nottingham Positive lessons from social care Promising international evidence Very new to the NHS A firm commitment to personal health budgets But begin by piloting Take time to evaluate, finding out what works Build on what works in other areas and link with them Many risks and complexities Personal Health Budgets (PHBs) are one part of the drive to personalise public services in general, and health services in particular. They are a way to allow people to take more control over how money is spent on their healthcare. evidence of the benefits of personalisation Who benefits most Where have PHBs Come From?

4. Working together for a healthier Nottingham -Hartlepool PCT with Stockton PCT -Doncaster PCT -Hull Teaching PCT -Manchester PCT -Merseyside (joint bid) -Stoke on Trent PCT -Health and Wellbeing Partnership, Birmingham -Barking and Dagenham PCT -Havering PCT -West London PCT - Dorset PCT -Norfolk PCT -NHS Nottingham City -Northamptonshire Teaching PCT -Oxfordshire PCT -Avon, Gloucestershire, Wiltshire and Somerset Cardiac and Stroke Network -Bedfordshire PCT -Eastern and Coastal Kent PCT -Medway PCT -Torbay Care Trust NHS Personal Health Budget Pilot Sites

5. Working together for a healthier Nottingham Nottinghams NHS Personal Health Budget Pilot To explore the use of Personal Health Budgets for: Patients with neurological conditions referred to the new Community Neurology Service Patients with memory problems referred to the Intermediate Care Service at the Willows Patients that become eligible for fully funded NHS Continuing Health Care or joint funded care packages Carers of patients receiving a Personal Health Budget

6. Working together for a healthier Nottingham NHS White PaperSpending reviewMental health strategy Carers strategy SEN Green Paper Right to Control NHS Operating Framework. Clear Government Support for PHBs NHS Future Forum and the Governments response October 2011 announcement that, subject to the evaluation, people receiving NHS Continuing Healthcare will have a right to ask for a personal health budget by April 2014

7. Working together for a healthier Nottingham PHBs: Key Points At the heart of a personal health budget is a care plan which is developed in partnership. Bringing together the clinical knowledge and expertise of professionals in partnership with the individuals knowledge of how their condition affects them and what works for them. The plan and the budget enables people to meet their needs in different ways, ways that work for them. Once it has been developed, the plan will be subject to clinical governance and sign off. Personal health budgets are not about new money; rather they use money which would have been spent on an individuals care in different ways. Personal health budgets aim to deliver better health and wellbeing outcomes through choice and control. They should facilitate integration across services.

8. Working together for a healthier Nottingham Step by Step Journey

9. Working together for a healthier Nottingham 5 Steps 1.How much? 2.Support Plan 3.Agree the Plan 4.Organise Support 5.Review

10. Working together for a healthier Nottingham Step 1- How Much? Based on the cost of providing the patient with commissioned services Continuing Health Care Resource Allocation System

11. Working together for a healthier Nottingham Step 2 – Support Plan Self Brokerage Brokerage – Internal (NCC) – External Directory of Services: – www.dowhatyouwant.org – www.nottinghamcity.nhs.uk/-your-services- /personal-health-budgets.html

12. Working together for a healthier Nottingham Step 3 - Agree the Plan Step 1 – Clinical sign off by lead clinician Step 2 – Commissioning sign off

13. Working together for a healthier Nottingham Step 4 – Organise the Support Notional individual budget Real budget held on the individuals behalf Direct payment – cash held by patient More direct control to individuals Already legally possible Personal care plans

14. Working together for a healthier Nottingham Step 5 - Review Review periods based on: – Patients condition – Risk – Clinical Agreement – Support Plan Period

15. Working together for a healthier Nottingham Patient Examples: Mental Health Petes Story – DVD

16. Working together for a healthier Nottingham Early Lessons & Key Challenges - 1 It is essential that health and social care work together to facilitate personalisation Personal Health Budgets arent for everyone People want help to develop a support plan and decide how to spend their budget Support planning is time consuming if it is done properly Fluctuating and changing need

17. Working together for a healthier Nottingham The culture change to facilitate personalisation in health is huge It is important to recognise and record risks Market development Delivering Personal Health Budgets in a time of financial challenge Developing the right systems and processes Early Lessons & Key Challenges - 2

18. Working together for a healthier Nottingham What Next - 1? To build on the lessons learnt throughout the PHB pilot to develop a sustainable, efficient and effective process for providing patients with a PHB in Nottingham.

19. Working together for a healthier Nottingham What Next - 2? Roll out for patients eligible for Continuing Health Care Roll out for joint funded patients Continue to offer PHBs to patients with neurological conditions accessing the Community Neurology Service Explore PHBs in childrens continuing care Explore PHBs in mental health, short term residential care Explore PHBs with patients with working age dementia living in the community Explore PHBs for people with ME

20. Working together for a healthier Nottingham Any Questions? Gemma Newbery Email: gemma.newbery@nottinghamcity.gov.uk Tel: 0115 883 9474