The Department of Health and Social Care (DHSC) has announced plans to increase the use of personal health budgets (PHBs) under which individuals are responsible for making decisions about their own care provision, which is paid for from an allocated sum of money.
PHBs are already a legal right for those in NHS Continuing Healthcare, and Clinical Commissioning Groups (CCGs) are able to offer PHBs at their discretion where appropriate. Patients of these services are not required to use PHBs, but providers are required to offer them. DHSC estimates 28,000 people had PHBs in 2017/18, rising to 40,000 to February 2019, and it plans to increase this to 200,000 by 2024.
The Government has now released its response to consultation on widening the legal mandate of the scheme. This is to expand to include a right to PHBs for ongoing care for:
- Social care needs
- Those with NHS-supported posture and mobility needs, including wheelchairs
- Former forces personnel
- Learning disabilities or autism
- Those previously detained under the Mental Health Act
The aim of PHBs is to improve integration in decision-making (particularly between health and social care), provide more tailored support thus improving individual care, and save money by avoiding spending on parts of standard approaches where these are not going to be helpful.
However, there have been some concerns around the additional burden that PHBs may place on patients and carers, especially in the case of vulnerable patients who may find it harder to make informed choices.