Learning from Northamptonshire Gill Ruecroft, Northamptonshire PHB - - PowerPoint PPT Presentation

Learning from Northamptonshire

Gill Ruecroft, Northamptonshire PHB Lead gill.ruecroft@nhs.net 01604 651121

Follow this link for the Northamptonshire PHB DVD, patients and staff describing their experience and the benefits of PHBs www.neneccg.nhs.uk/personal-health-budgets

What is a PHB?

A person, working in partnership with their clinician, knows how much their health care costs, is supported to write a personal plan and is able to purchase services that enable them to lead a safe and fulfilling life. PHBs enable people with LTCs to have choice, flexibility and control over the healthcare and support they receive, selecting services that meet their needs in a way that is most appropriate for them

Understanding/believing the concept

• Use the results of the national evaluation
• Back up with real stories
• Other sites’ experience
• Myth busting/perceived risks
• Interview people with complex needs, where

traditional services have not met those needs

• Clinicians can often identify these patients
• Identify people who want to have a go and dive in!

Identifying the budget

• Our most difficult element
• Influencing managers – what’s in it for them
• Use tested tools/models
• Transparency
• Cost neutral
• Invest to save
• Pump priming

Clinical/User Leadership

• Clinical champions
• Support them to test
• Put them in touch with others who are doing it
• User champions
• Focus groups, feeding back experience, used to

develop systems/processes

• Peer network development

http://www.peoplehub.org.uk/

Designing the processes/systems

• Designed in partnership by users, providers

and commissioners

• Personal plan is the key to making PHB work

and coordinate integrated services

• Commission existing services i.e. council

payment and monitoring for PBs

• New role required: support, advocacy and

brokerage

• DH guidance documents

Measuring outcomes

• For the pilot
• Progress/achievement of health outcomes
• Quality of life
• Cost of care comparison
• Beyond a pilot
• New measures for all LTCs
• Include as part of QIPP in the future

Things we have learnt in the last 3 years

• PHBs are not for everyone
• The culture change to a personalised approach is huge, change
• f conversations, relationships – NHS staff and patients
• Managers/budget holders, who do not have patient contact,

are difficult to engage

• Most patients/representatives do understand PHBs
• Most people are very responsible with the money
• Personal planning is time consuming if done properly, most

people need support

• It is easier than we thought to identify measurable outcomes
• Important to focus on outcomes, not on what they are buying

Continued……………..

• Patients must be involved in the design of the

processes/systems to get them right

• Market development is required so people have real choice
• Tension – current provision/decommissioning to release

savings

• Integration – one budget and one plan for all needs
• This is much more complex and much harder to implement

than we envisaged!

Improved quality = reduced demand on services

Questions?