Phbs children_17.1.14 final
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Transcript of Phbs children_17.1.14 final
Implementing personal health budgets for children with continuing healthcare
Julie Stansfield, Sue Bottomley and Michael Chew17th January 2014
How to participate today
Presenters
• Julie Stansfield, Chief Executive of In Control and Health Programme Lead
• Sue Bottomley, In Control associate & lead for NHSE programme
• Michael Chew, Assistant Director Children’s Commissioning, Wigan Council/Wigan Borough CCG
Agenda
• National overview and context• NHSE programme & priorities• Implementation on a local level – The
Wigan experience• Wider support available to CCGs &
councils• Questions
Julie Stansfield:National update & context
To edit footer go to: View> Header and Footer
NHS White PaperSpending review
Carers’ strategy
SEND Green Paper
Right to Control
NHS Operating Framework.NHS Future Forum
and the Government’s response
October 2011 announcement that, subject to the evaluation, people receiving NHS
Continuing Healthcare will have a right to ask for a personal health budget by April
2014This was followed up by an
announcement of a “right to have” and from 2015 extension to other long term
health needs who would benefit.
5 distinctive features:
• The person knows how much money they have upfront .• The person chooses the outcomes to be achieved, in
agreement with their health professionals.• The person is enabled to create their own support plan,
with whatever support they may want.• The person freely chooses the way in which their budget
is held and managed. • Whichever option is chosen to hold and manage the
money, the person is able to spend it flexibly, to achieve their planned outcomes.
What is a personal health budget?
Personal health budgets are just one part
Personal health budgets are just one part of the drive to personalise public services in general, and health services in particular
Personalised care planning
Personal health
budgets
Right to Control pilots
Special Educational
Needs & Disabilities
(SEND) pilots
Choice, including choice of
provider, GP, treatment
and Choose & Book
Self-directed support
Personal budgets in social
care
Our overall approach
Who can have a personal budget?• Anyone who wants one. Needs should be such that a
budget can be reasonably set
What can a budget be spent on? • Not emergency care or core GP services• Agreed care plan with agreed health and wellbeing
objectives• Services should be appropriate for the state to
provide – not gambling, debt repayment, alcohol, tobacco
Mirror social care wherever possible
Different ways of delivering a personal health budget
• Notional
individual
budget
• Real budget held on
the individual’s
behalf
• Direct payme
nt – cash
held by patient
•M
ore d
irect co
ntro
l to
ind
ividu
als
• Personal care
• plans
• From Aug• 2013
NHSE Programme 2014
We are expecting to see;
• A planned approach to offering personal health budgets for continuing health care for children and young people. This activity to have already successfully supported a number of families to take up a personal health budget for their son or daughter’s health support
• Work underway to link approaches to assessment, decision making and the allocation of funding for personal health budgets for continuing health care -and the linked work needed to re-design a local approach to the commissioning and de-commissioning of existing services and provision to ensure that support is available to families if they take up the option of a personal health budget
• A strong, active and committed local partnership with a positive approach to continuing health care and willingness to make the changes needed, remove barriers and positively promote personal budgets for CHC. This may include amending eligibility criteria and consequent increases in the number of children and young people receiving CHC funded packages (this will depend upon the existing offer, the decision making process and the current number of children and young people with CHC support)
Sue Bottomley: NHSE Programme
Expressions from 10 sites – 4 selected.
Over next six months we will:• Identify local priorities and offer specialist site
support from In Control Children’s Team• 5 regional events focused on health and its
responsibility and requirements for implementation of C&F Bill
Priorities for Continuing Health Care PHBs
• Agreeing scope – what’s in – what’s out• Agreeing transparent systems and processes• Workforce development –paradigm shift• Developing meaningful metrics• Ensuring transferability and connection to
personalisation and individual budgets• High end support – ensure targeted
services are fit for purpose
SEN:D Pathfinder and Personalisation in Wigan
Michael ChewAssistant Director: Children’s
CommissioningWigan LA/Wigan Borough Clinical
Commissioning Group
SEN:D Green Paper (Sept 2011)
• Background and Context• Low aspirations • A flawed system (adversarial)• Limited choice and control• Segregated• Difficult to understand/navigate• Bureaucratic
Wigan Context
• Integrated commissioning model• Integrated care• Partnership• Care in the community (CHC)• Aiming High legacy (Direct Payments)• Special Schools review
Key areas of development
• Education, Health and Care Plans• Integrated pathway and infrastructure• Integrated Personal Budgets• Personalisation (Real Wealth)• Workforce design (modernising services)• Parent Engagement• Local Offer
Achievements in Wigan
• 44 EHC Plans with 11 personal budgets (including some with NHS funding)
• Positive outcomes for families • PHBs (Continence products and Wheelchairs)• Integrated keyworking offer• Personalisation of NHS services • Restructured parent engagement• Developed a Local Offer
Challenges and Opportunities
• Implementing whole system change• A vision for PHBs (what is possible?)• Resource Allocation System• Transparency (a local offer for healthcare)• Sustainability (outcomes and efficiency)• Market development• Engaging stakeholders (families and
providers)
Summary
• Improved the patient experience• Increased choice, control, empowerment• Personalisation not just PHB• Key contribution from NHS workforce• Requires whole system change
Wider support available
• Health and Children’s programmes:– Build on national support available– Practical, on-site support– Membership community– Bespoke support available
www.in-control.org.uk/health
www.in-control.org.uk/childrens
Any questions?
Further information and contact details
www.in-control.org.uk/health
www.in-control.org.uk/children
www.in-control.org.uk/news/e-newsletter