Evaluation of the Personal Health Budgets Pilots
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Transcript of Evaluation of the Personal Health Budgets Pilots
Personal Health Budgets Evaluation
Evaluation of the Personal Health Budgets Pilots
Julien Forder1, Karen Jones1, James Caiels1, Paul Dolan2, Caroline Glendinning3, Dominic King4 and Karen Windle1
Personal Social Services Research Unit1 (Kent)Department of Social Policy2 (LSE, London)Social Policy Research Unit3 (York)Imperial College, London4
Personal Health Budgets Evaluation
Personal Health Budgets (PHBs)
Central to the government’s ambition to ‘modernise’ health care …
… at the heart of the ‘personalisation’ agenda …
… to promote choice
Build on experiences from social care and Individual Budgets
In 2009 – DH invited PCTs to become pilots
Personal Health Budgets Evaluation
Promoting choice
Diversity
Information
Empowerment
Control
Personal Health Budgets Evaluation
Hypothesised benefits of PHBs …
• Wider choice of options for spending to give flexibility …
• … and more control over resources so people can access them
• Greater personal freedom and independence
• Self-esteem and sense of identity would be greater
• Quality of life would be improved …
• … cost-effectively
Personal Health Budgets Evaluation
Aims of the evaluation
CORE QUESTION Do PHBs ensure better health and social care outcomes when compared to conventional service delivery
If they do work, how best can PHBs be implemented
User experience
Carer impact
Workforce
Commissioning/Provider impact
Outcomes
Costs
Cost effectiveness
Evaluation dimensions
Personal Health Budgets Evaluation
Design• Controlled trial without randomisation across 20 PCTs• Overall sample – 2000 across different deployment options and health
conditions– NHS Continuing Healthcare– Diabetes– Chronic Obstructive Pulmonary Disease– Stroke– Mental health– Long-term neurological conditions
• 1,000 patients will be recruited to the PHB group • 1,000 patients will be recruited to the comparison group
• Two specialist services: end of life and maternity
Personal Health Budgets Evaluation
Recruitment Process• Different groups of HPs
to decide and recruit– A group of HPs offer PHBs and
recruit to the PHB group– In same site, a different group
of HPs decide who is approached to be in the Comparison Group
– Min of 75 to be recruited to the PHB and Comparison Group
• Same group of HPs to decide and recruit to both groups – Selection bias more of a
problem– Randomisation before the offer
of PHB– Min of 75 to be recruited to the
PHB and Comparison Group
Personal Health Budgets Evaluation
Importance of the recruitment process
• Robust evaluation key to understanding the impact of PHBs
– whether they work– for whom they work– whether they are the most effective way of providing
services– how to make them work best
Personal Health Budgets Evaluation
Individual Level Data Collection
Qualitative interviews about user experiences (55 PHB holders & carers)
1. Outcome data2. Medical records3. HES data
1. Outcome data2. Medical records3. HES data4. Care plans (PHB holders)
3 months
Outcome data
9 months
Qualitative interviews about
user experiences (55 PHB holders
& carers)
6 monthsBaseline 12 months
Personal Health Budgets Evaluation
Specialist Services• 10 in-depth interviews with budget holders
using maternity services – after the birth
• 10 in-depth interviews with carers of PHB holders - end of life services – 6 months after the death of the budget holder
Personal Health Budgets Evaluation
Organisation Level Data Collection
Web-based questionnaire –
front-line operational staff
Face to face interviews -
Implementation
1. Face to face interviews – perceived success2. Face to face interviews - Impact on organisations3. Web-based questionnaire – impact on the workforce
3 months
Face to face interviews – project
leads
15 months
Telephone interview – progress of
implementation
12 months3 months 24 months
Personal Health Budgets Evaluation
Research design …… a few challenges
• Broad range of policy aims to be evaluated
• Variety of patient groups
• Need to collect data from busy people
• Diversity in local information systems
• The world is not standing still …control group
Personal Health Budgets Evaluation
Evaluation progress to date• Research and Development approvals• Implementation interviews• Impact on workforce – operational staff: to
begin• www.phbe.org.uk
Personal Health Budgets Evaluation
Some key dates…• Recruitment begins April 2010; ends April 2011• Fieldwork to end by April 2012• Interim reports:
– 1st - Early implementation issues: June 2010– 2nd – All implementation issues: November 2010 – 3rd – Cost of implementing PHBs: May 2011 – 4th – Early experiences of PHB holders and carers: July 2011– 5th – Satisfaction of PHB holders and carers: May 2012
• Final report due in October 2012