Hear the word ‘extension’ and chances are you automatically associate it with Brexit, these days. But Halloween 2019 saw what millenials would call a ‘retro’ use of the word, dating from a time when ‘sick’ wasn’t a compliment and ‘woke’ was a verb, as the Minister of State for Care, Caroline Dinenage MP, rose to announce to the House of Commons that legislation is afoot to extend the legal right to have a personal health budget (PHB) to two further groups:
- Individuals eligible for section 117 aftercare (who can, of course, already receive care in the form of direct payments); and
- People who access wheelchair services, whose posture and mobility requirements impact upon their wider health and social care needs.
Back in the New Year, NHS England published Universal Personalised Care: Implementing the Comprehensive Model, setting out how the NHS Long Term Plan commitments to PHBs would be delivered by 2023/24, in what it called an “exponential expansion in the roll-out of personalised care”.
The formal rationale is that:
The evidence base for personalised care demonstrates a positive impact on people, professionals and the system. It has been shown to produce better outcomes and experiences, improving individual’s quality of life, whilst reducing health inequalities. It has also demonstrated the ability to reduce pressures on the system - people who are more confident and able to manage their health conditions have 18% fewer GP contacts and 38% fewer emergency admissions than people with the least confidence.
What we know in practice is that, whilst PHBs work extremely well for some individuals, other people find the burden of their physical or mental health conditions quite sufficient, without having to organise their own care. For yet others, the system provides opportunities for abuse, generating still further work for commissioners trying to keep packages of care on track.
There is clearly no holding back the tide, however; with over 70,000 people currently in receipt of a PHB, the target of 2.5 million individuals by 2023/24 remains current policy. The two groups referred to above will have their ‘right’ to a PHB enshrined in law on 2 December 2019.