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