In this slideshow, Gill Ruecroft, Northamptonshire Personal Health Budget Lead, outlines the ways in which personal health budgets can work within the new commissioning landscape, detailing the need for integration of different sectors across health and social care. Gill Ruecroft presented at the Nuffield Trust seminar: Where do personal health budgets fit in the new commissioning landscape? in May 2012.

1. Integrating Personal Health Budgets into
the new landscape of clinical
commissioning
Northamptonshire Integrated Care Partnership

2. Learning from PHB
• Health professionals/patients working in partnership,
different conversations, real choice & control
• The plan is the key to coordinate integrated services
• New role required - support, brokerage and advocacy
• Improved quality = reduced demand on services
• Tension – current service provision/decommissioning
to make savings real
• This was much more complex and difficult to
implement than we envisaged – its not a QIPP fix!
Northamptonshire Integrated Care Partnership

3. New County Landscape
• CCGs x 2
• Nine localities
• Mirrors local authorities boundaries
• NHFT (community services provider)
provision locality based
• 3rd sector tend to be locality based
• Health & Well Being Fora in each locality
Northamptonshire Integrated Care Partnership

4. LTC integrated model pilots
Two pilots in Northamptonshire working from
one agreed model concept
• Daventry
– Risk stratification approach
– Based on MDT and use of specialists
– Centralised
• Kettering
– Not condition specific, high users of emergency services
– Generic team who coordinate an individualised MDT
– Practice based
Northamptonshire Integrated Care Partnership

5. HOUSING
VOLUNTARY NEIGHBOURHOOD TEAM SOCIAL SERVICES
INDIVIDUAL
PLAN
FRIENDS
FAMILY
MENTAL HEALTH NURSES
MDT
H&SC NEEDS
H&SC OUTCOMES TO ACHIEVE
THERE IS NO “CURE”… THIS IS ABOUT MANAGING AND LIVING YOUR LIFE
Northamptonshire Integrated Care Partnership

6. • LTC integrated pilots - MH low level support
to start with
• Exploring how to commission PHBs further
this year
• Develop a CQIN for inclusion in 2013/14
contracts
• Future plan, to include in LTC integrated
model
Northamptonshire Integrated Care Partnership

7. Claire - in her early twenties, using MH services for 4 years, has been unwell
since she was 17. When Claire applied for her PHB she was living with her
parents. Last year 9 contacts with crisis resolution team and 67 inpatient stays.
• Total cost of health care 12 mths previous = £56,291.89 (excl medications)
• PHB = £12,930.56 (planned spend to date £10,426.00)
• Claire’s progress against the outcomes in her plan she aimed to achieve:
No inpatient stays, one contact with the crisis resolution team
Reduced contact with care coordinator, from 2 weekly to 4 weekly
Self harmed twice (‘Nowhere as many as I used to’)
Weight loss, new clothes, improved self esteem
Reduced reliance on family, living more independently, in control, making decisions
• Claire’s plans for next year and the future
To complete year 2 of college course
Make more new friends and move to next level of independent living
Continue to stay out of hospital
To work in a Zoo – dream…to work in another country on and endangered breeding programme
Northamptonshire Integrated Care Partnership

8. Northamptonshire Integrated Care Partnership