NHS England plans personal budgets covering NHS and social care

This represents the introduction of capping of NHS users’ previously open ended entitlement to NHS care. The pamphlet states that ‘Local authorities and NHS commissioners and providers will be offered dedicated technical support and regulation and financial flexibilities to address systemic barriers to change’: presumably this means that bribes will be used to sugar the pill – no doubt these ‘flexibilities’ wuold disappear once the system was up and running so that insurance companies could begin to offer cover for the top-ups that would then be required.

David Williams

HSJ, 4 September, 2014

NHS England has proposed devolving “year of care” budgets covering NHS and social care to individuals with complex needs as part of its effort to help integrate services and increase personalisation.

In a prospectus published this week [http://tinyurl.com/pxv7pb7], the commissioning body set out plans to introduce “integrated personal commissioning” in areas keen to make rapid strides towards creating joined up, personalised care.

The programme will be based on two elements: personalised support and advocacy to give individuals a greater say in the services they receive; and capitated “year of care” budgets, devolved to individual service users with complex needs.

NHS England hopes putting service users in charge of single budgets – based on the amount spent on health and social care over a year – will ease the shift towards preventative care.

Its prospectus argues that fixing the amount of money available per patient per year would encourage providers to identify and intervene in cases where patients are at risk of deterioration. NHS England hopes the approach will be used for patients such as children with complex needs; frail older people; those with learning disabilities; and patients with significant ongoing mental health needs.

Under the voluntary programme, adopting areas will be offered technical support and “regulation and financial flexibilities” to tackle barriers to implementation.

NHS England is asking clinical commissioning groups and councils to apply to take part in the initiative, which will run for a minimum of three years from 2015-16.

The organisation’s chief executive Simon Stevens said: “Kate Barker and the King’s Fund commission has today rightly described the need for more integrated health and social care for people who need care and their families. While the longer-term debate on how we get there is crucially important, so too is the need to deliver for people today.

“That’s why, for the first time since 1948, from next year integrated personal commissioning means we will start offering fully combined health and social care funding, under the direct control of people using those services.”

The programme was first announced by Mr Stevens in July.