Personal Health Budget

Researchers at SPRU have interviewed people taking part in the pilot of Personal Health Budgets (PHB) in England, 9 months after they had been offered their own budget. The overall picture emerging from our findings is one of appreciation for the new way of funding, together with improvements in health and well-being; for the people with long-term health problems, and for their carers and family members. Problems and delays have also played a role in the implementation, sometimes threatening to undermine the good that the PHB has done.

People found that PHBs:

• increased their sense of control over their illness and treatment
• led to improvements in mental health
• led to less use of services facilitated
• greater continuity of care.

The access to services not normally provided by the NHS was another benefit of the scheme. People used it to take part in exercise, or activities that improved self-confidence and their social lives, which then led to reduced use of GP services and prescriptions. The increased health of the budget holders or use of PHBs to provide care, led to less demands and stress on family and informal carers. Most people interviewed felt that they were best placed to know their own needs and what would make them feel better.

There were however problems with the implementation. People recounted the frustration of having their requests for services refused by PCT staff who had responsibility for signing the care/support plans. There seemed to be a lot of confusion amongst people and between different PCTs as to what PHBs could be used for; particularly whether budgets had to be limited to narrow health-related uses or could be used for wider well-being gains. There were a lot of delays reported: first in getting approval and then with setting up the services. These could cause disappointment and distress.

For more details you can download the report, which includes an executive summary,
by clicking this link: http://php.york.ac.uk/inst/spru/pubs/2222/

Reablement

Home care re-ablement is high on the English adult social care policy agenda.
It aims to help people regain skills and confidence so they can live as independently as possible, thus reducing needs for longer-term home care services. However, little is known about what re-ablement involves or how best to organise services. 

This first study of five well-established re-ablement services shows which features are considered to contribute to success.

The findings reported here constitute part of a larger study into the long-term impact of home care re-ablement services.

The full report and a summary are available from:
Full Report

Habitual Complainers

 

Posted on February 24, 2011 by informededucation
I just read a fascinating article that had been tweeted by @gcourous – “Finding fascinating goals”. This great article contains a little gem:

“Habitual complainers usually have more goals for others than they have for themselves.”

This is a lovely statement, and if you listen to habitual complainers you would certainly think this was true.

However, I am confident that if you dug a little deeper in to the brains of these critics and cynics you would find just as many goals. The difference? These people are losing faith in their ability to meet them, and have been so stung by criticism and nagging self-doubt that they are lashing out other people instead.

Really, it’s just a version of “it isn’t fair!”, or at an even more basic level, complainers are voicing their basic low-level fight or flight response.

Listen to any prominent education critic on either side of the debate and somewhere underneath the self-righteousness there is someone who desperately wants to make a difference and improve things. The more viciously they are attacked for their suggestions the more aggressively they will fight back, complain, and criticise.

In both the USA and the UK I’ve seen prominent figures on both sides of the argument struggle to make their arguments under a siege of criticism. Each side sees the other as habitual complainers and attacks them. Many of them stop even trying to engage with their opposite numbers and start preaching to the converted instead. This inevitably ends up with a lot of one-sided I-told-you-so-isms and I’m-more-on-the-side-of-kids-than-you-ness.

On a lower level we see the same in schools. Leaders pushing unpopular reforms end up becoming entrenched and sit with their colleagues and criticise ‘problem’ staff and lick their wounds. Teachers sitting in staff areas laughing and criticising management as part of their daily routine. Both sound dismissive of the other, but they all really want the school to be a better place despite the rhetoric.
Of course everyone needs to blow off a little steam at times, but where jokes turn in to a destructive habit, there’s something wrong with the culture.

It starts at the top. If teacher, unions, media and politicians could stop attacking each other for cheap point-scoring then they’d start to see that their targets have just as many goals and dreams as they do. We need to get less defensive, admit our own mistakes, and make ourselves feel better by helping others with their own goals.

I’d love to see the teaching unions engage alongside the government instead of both sides accusing the other of greedy and wicked hypocrisy and assuming any new measure is a weapon to be used against them. I’d love to see the Twitter community engage in finding the hidden gem of an idea in the tweets of people they dislike, instead of ganging up and attacking them (as I blogged before)
I saw a great quote in Richard Branson’s book Business Stripped Bare, where he recounts something told to him by the Dalai Lama:

“If you wish to experience peace,
provide peace for another.
If you wish to know that you are safe,
cause others to know that they are safe.
If you wish to understand seemingly incomprehensible things,
help another better understand.
If you wish to heal your sadness or anger,
seek to heal the sadness and anger of another.
Those others are watching you now. They are looking to you for guidance, for help, for courage, for strength, for understanding, and for assurance at this hour.”

Definitely food for thought.
I hope I’m not just being overly optimistic or idealist.

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Risk Assessment

A very good training on Risk Asssessment, mainly in mental health,
however still relevant to my post for dual diagnosis cases.