Personalisation and Personal Health Budgets for people receiving CHC
The Staffordshire WayPersonal Health Budgets
The Gnosall Pilot The Staffordshire Personal Health Budgets (PHBs) pilot began in April 2010 and became one of approximately 60 pilot sites across the country. Dr Ian Greaves - previous project to provide Dementia Services, he agreed to be the clinical lead for a PHB pilot project within Gnosall Surgery – focused on patients who have one or more Long Term Condition with a high dependency on their GP or secondary care.
The Gnosall Pilot 168 patients identified as being frequent flyers were invited into the practice for an initial discussion of PHBs, and 12 patients identified as frequent flyers by the CCG. 60 patients identified as having dementia have had case discussions. These have all had care plans and reviews. 32 patients determined to be frail elderly have had case discussions 33 patients have opted to join the Prevention Plan
Findings There is no common source of information on what support is available in social care or health, especially community provision, including who does what, how much it costs and what the added value is. Calculating the individual financial envelope is easier for social care since the care plan is costed for individual needs and this is not currently the case in the NHS Personalisation training is required for health staff. Health staff tend to look at care planning in a service focussed way rather than being person centred. Transferrable learning for all areas of service – Learning Disability, Mental Health etc
What is difference between a care plan and a care plan with a PHB? Dr Greaves stated that what he has learnt is that a personal care plan is key to everything. It clearly defines medical and social care needs and the patient and family owns the care plan. The care plan sets out their needs in holistic way, as a person and an individual and what their outcomes will be. The delivery plan or action plan states; who will need do what by when who will pay for it how it will all come together what needs commissioned by health care and social care professionals and this is what makes it a true Personal Health Budget – it is tailored to the person’s lifestyle which really is WHAT PERSONALISATION IS ALL ABOUT! It is an innovative way of meeting needs and delivering outcomes and being very clear about the budget available to do it.
Key milestones in the county January 2011 A showcase event to bring Cabinet Members and Department of Health officials together to promote the Personal Health Budget Project. June 2011 - first child PHB in the country
Collaborating across Staffordshireevent A countywide networking event was held in April 2011 attended by 75 people including over 40 GP’s Speakers; National Clinical Director of Public Health for England Dr David Colin-Thomé OBE Local GPs Dr David Hughes from Leek and Dr David Palmer from Stafford. Included a market place of 18 information stalls featuring local public and voluntary sector services to promote the wider wellbeing agenda beyond health and social care.
Come to Staffordshire! Professor Stephen Field, Chair of the Governments NHS Future Forum visited Gnosall Surgery on 12th August 2011 More recent visitors during 2012; John Wilderspin, National Director for Health & Wellbeing Board Implementation Baroness Jolly, Co-Chair of the Parliamentary Party Committee on Health and Social Care
Year of Care Funding model 1 of 7 prestigious national Early Implementer sites for The Year of Care Funding Model The Staffordshire application was fronted by Staffordshire and Stoke NHS Partnership Trust and the Fit for the Future Programme in the North of the county with support from the Joint Commissioning Unit The aim is to have a national funding model that facilitates the delivery of integrated health and social care for people with a LTC based on need rather than disease.
Where are we now with PHBs? New Project Manager – Matthew Oakley Setting up GP pilots - 11 expressions of interest throughout the county including Working with voluntary sector – Headway and Staffordshire Buddies Continuing Health Care work Proposed event and training opportunities in the pipeline
THE QUIZ!Aromatherapy massage once a week atthe local beauty salon To reduce stress levels To improve flexibility and ease muscle pain
A Personal Trainer like WAG’s have, andthe people off The Only Way is Essex To improve health and fitness levels Self care / management opportunities being taught by a professional
A subscription to Sky (including Sky Sportsand Sky Movies) To be able to pursue my hobby of watching films Watch my favourite sports team More cost effective than PA taking person to cinema / football matches My friends can come round for film nights / sports nights
Examples of Uses of Personal Health Budgets (forpeople with long term health conditions) Purchase of personal exercise equipment, including treadmill, exercise bike, bicycle Personal Health Trainer Massage to improve circulation and pain relief Alternative therapies such as aromatherapy for pain relief and relaxation (reduce anxiety) Alternative approaches to smoking cessation Ways of promoting healthy eating and/or weight loss, for example kitchen equipment, bathroom scales, cost of joining a slimming club Ways of reducing social isolation, especially for those who are depressed. This could include funding leisure activities/hobbies that keep people occupied/stimulated and involve accessing the local community (providing opportunities to socialise) Equipment required to undertake leisure activities/hobbies (see above) for example art materials or sporting equipment. Travel expenses to access universal services or to pursue leisure activities (see above) To enable the service user to be accompanied on an activity, where this is necessary Purchase of air-conditioning or de-humidifying equipment (for people with breathing difficulties) Equipment to improve access around the home, for example modular ramps to improve access to different parts of the home or garden for wheelchair users http://www.supportplanning.org/Support_Planning_Downloads/%20Personal%20Health%20Budgets,%20whats%20in%20and%20whats %20out%20(draft)v2.doc