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Debating personal health budgets

  • Vidhya Alakeson (a1), Jed Boardman (a2), Billy Boland (a3), Helen Crimlisk (a4), Charlotte Harrison (a5), Steve Iliffe (a6), Masood Khan (a7), Rory O'Shea (a8) and Janet Patterson (a9)...
Summary

Personal health budgets (PHBs) were piloted in the National Health Service (NHS) in England between 2009 and 2012 and were found to have greater positive effects on quality of life and psychological well-being for those with mental health problems than commissioned service, as well as reducing their use of unplanned care. The government intends to extend PHBs in England for long-term conditions, including mental health, from April 2015. Given the importance of engaging clinicians in the next phase of PHB development, we provide an overview of the approach, synthesise the evidence from the national pilot and debate some of the opportunities and challenges. Balancing individual choice and recovery with concerns for risk, equity and the sustainability of existing community services is the central tension underpinning this innovation in mental health service delivery.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Jed Boardman (jed.boardman@slam.nhs.uk)
Footnotes
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Declaration of interest

V.A. has worked as an independent consultant for the Department of Health, England and is mental health lead for the Personal Health Budgets Delivery Programme, NHS England.

Footnotes
References
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1 Department of Health. Personal health budgets to be rolled out. Department of Health, 30 Nov 2012 (https://www.gov.uk/government/news/personal-health-budgets-to-be-rolled-out).
2 National Mental Health Development Unit. Facing Up to the Challenge of Personal Health Budgets: The View of Frontline Professionals. NHS Confederation, 2011.
3 Coulter, A, Roberts, S, Dixon, A. Delivering Better Services for People with Long-Term Conditions: Building the House of Care. King's Fund, 2013.
4 Webber, M, Treacy, S, Carr, S, Clark, M, Parker, G. The effectiveness of personal budgets for people with mental health problems: a systematic review. J Ment Health 2014; 23: 146–55.
5 Forder, J, Jones, K, Glendinning, C, Caiels, J, Welch, E. Evaluation of the Personal Health Budget Pilot Programme. Department of Health, 2012.
6 Boston College National Resource Center for Participant-Directed Services, University of Maryland, Human Services Research Institute. An Environmental Scan of Self-Direction in Behavioral Health. Robert Wood Johnson Foundation, 2013.
7 Epstein, AM, Fiscella, K, Lesser, CS, Stange, KC. Why the nation needs a policy push on patient-centered health care. Health Affairs 2010; 29: 1489–95.
8 Welch, E, Caiels, J, Bass, R, Jones, K, Forder, J, Windle, K. Implementing Personal Health Budgets Within Substance Misuse Services, Final Report. Department of Health, 2013.
9 Slasberg, C, Watson, N, Beresford, P, Schofield, P. Personalization of health care in England: have the wrong lessons been drawn from the personal health budget pilots? J Health Serv Res Policy 2014; 19: 183–8.
10 Campbell, N, Cockerell, R, Porter, S, Strong, S, Ward, L, Williams, V. Final Report from the Support Planning and Brokerage Demonstration Project. Office for Disability Issues, 2011.
11 Jones, K, Forder, J, Caiels, J, Welch, E, Windle, K, Davidson, J, et al. The Cost of Implementing Personal Health Budgets. Department of Health, 2011.
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
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Debating personal health budgets

  • Vidhya Alakeson (a1), Jed Boardman (a2), Billy Boland (a3), Helen Crimlisk (a4), Charlotte Harrison (a5), Steve Iliffe (a6), Masood Khan (a7), Rory O'Shea (a8) and Janet Patterson (a9)...
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