Individual Emporwerment in Kent

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Personal Health Budgets. Kent County Council and NHS Eastern and Coastal Kent …

Personal Health Budgets. Kent County Council and NHS Eastern and Coastal Kent
Presentation by Project Manager Georgina Walton

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  • 1. Individual Empowerment in Kent
    Georgina Walton
    Personal Health Budgets
    Project Manager
    Kent County Council and NHS Eastern and Coastal Kent
  • 2. Individual Empowerment in Kent
    1. Kent: Overview
    2. Transforming Health and Social Care
    3. Personalisation within Kent Adult Social Services
    4. Kent Card
    5. Personal Health Budgets
  • 3. Individual Empowerment in Kent
  • 4. Individual Empowerment in Kent
    Overview of Kent
    • Population: 1.4 Million People
    • 5. Variations of Deprivation
    • 6. Challenge of Ageing Population:
    By 2026it is expected:
    People aged 85+ to increase by 100%
    People 75+ to increase by over 60%
    People 65+ to increase by over 30%
    In Kent it is expected:
    85+ 2,900 new dementia cases
    65+ 8,310 new dementia cases
  • 7. Individual Empowerment in Kent
    Health and Social Care in Kent
    2 Primary Care Commissioning Trust
    3 Acute NHS Hospital Trusts
    1 joint NHS & Social Care Mental Health Trust
    1 Ambulance Trust, 1 Fire Service, 1 Police Service
    1 Adult Social Care Services
    On a typical day…..
    20,000 people see their Doctor
    50,000 prescription items are dispensed
    32,000 people are supported to live independently
    60,000+ people work in the health & social care sector
  • 8. Individual Empowerment in Kent
    1. Kent: Overview
    2. Transforming Health and Social Care
    3. Personalisation within Kent Adult Social Services
    4. Kent Card
    5. Personal Health Budgets
  • 9. Individual Empowerment in Kent
    Transforming Health and Social Care
    • Initially born out of the disability rights movement in the late 1970s
    • 10. The first legislation allowing Direct Payments for social care was passed in 1996, in the Community Care (Direct Payments) Act.
    • 11. Our Health, Our Care, Our Say: A new direction for community services (published 2006)
  • Individual Empowerment in Kent
    1. Overview of Kent
    2. Transforming Health and Social Care
    3. Personalisation within Kent Adult Social Services
    4. Kent Card
    5. Personal Health Budgets
  • 12. Individual Empowerment in Kent
  • 13. Individual Empowerment in Kent
    Achieving this by:
    • Information, advice and guidance
    • 14. Carers assessments and support
    • 15. Assistive technology
    Telecare and Telehealth
    • Enablement Services
    6 weeks intensive free support
    • Consultation with Communities
    • 16. Personal Budgets
  • Individual Empowerment in Kent
    Person agrees with Social Services how their needs will be met
  • 17. Individual Empowerment in Kent
    Personalisation within Adult Social Services
    Personal Budgets
    An allocation of funding that can be used to purchase support from the public, private or voluntary sector, managed by:
    • Social Services
    • 18. Private or voluntary provider
    • 19. Individual as a Direct Payment
    Must be used on meeting assessed social care needs
  • 20. Individual Empowerment in Kent
    Direct Payments
    Used by people to make their own arrangements
    Duty to offer this to virtually all people, including families of people who lack mental capacity
    Can be paid to:
    • Bank account
    • 21. Kent Card
  • Individual Empowerment in Kent
    1. Kent: Overview
    2. Transforming Health and Social Care
    3. Personalisation within Kent Adult Social Services
    4. Kent Card
    5. Personal Health Budgets
  • 22. Individual Empowerment in Kent
    Brief History
    • A new streamlined and cost effective solution was required for delivering direct payments
    • 23. A system was needed for people who have been excluded in the past from having a direct payment
    • 24. Kent County Council in partnership with The Royal Bank of Scotland developed a system that would revolutionise the direct payment process
  • Individual Empowerment in Kent
    The result was the first pre-loaded card programme for Direct Payment recipients
    ‘The Kent Card’
    Launched March 2007
  • 25. Individual Empowerment in Kent
    Why did KCC introduce Kent Card?
    • To support the personalisation agenda in social care and empower individuals
    • 26. Reduce the complexity around direct payments:
    - Kent Card removes the need to negotiate the opening of a bank account
    - Each card is pre loaded with an agreed amount
    Flexibility, Freedom, Choice and Control
  • 27. Individual Empowerment in Kent
    Application Form
    RBS
    Cardholder detail spreadsheet
    Crediting
    How the card works…..CARD ISSUING & LOADING
    Monthly Statements & Daily Web-access
    Within
    9 Working
    Days
    Funds Loaded
    - Day 3/4
  • 28. Individual Empowerment in Kent
    Kent Card Features
    • The ability to block spending in certain Merchant groups
    • 29. Cash facility is automatically restricted
    • 30. Monthly statements
    • 31. Detailed management and audit information reporting
    • 32. KCC 24hr helpline
    • 33. Personal Assistants can be paid via Kent Card
    • 34. Cardholder can nominate an additional cardholder
  • Individual Empowerment in Kent
    Benefits for Providers who accept Kent Card
    • Payment credited to providers accounts directly, this reduces processing time and associated costs
    • 35. Users of direct payments is set to increase
    • 36. Providers are added to a list of UK suppliers that accept VISA
    • 37. Providers are added to the Kent County Council website showing that they accept Kent Card
    • 38. Increased business opportunities with the facility of accepting VISA
  • Individual Empowerment in Kent
    Award winning Kent Card
    Winner at the VISA European Awards
    ‘Best corporate social responsibility programme’
    Kent Card was shortlisted for Innovation and Progress at Guardian Public Service Awards 2009 and The pre-paid awards 2009 category- Best Corporate or Government loaded programme
  • 39. Individual Empowerment in Kent
  • 40. Individual Empowerment in Kent
    1. Kent: Overview
    2. Transforming Health and Social Care
    3. Personalisation within Kent Adult Social Services
    4. Kent Card
    5. Personal Health Budgets
  • 41. Individual Empowerment in Kent
    Backdrop
    “ You have the right to make choices about your NHS care and to information to support these choices. The options available to you will develop over time and depend on your individual needs.”
    (Section 2a of the NHS Constitution)
  • 42. Individual Empowerment in Kent
    What’s involved?
    There are 4 key stages Personal Health Budgets
    Managing the
    plan and getting
    the care
    e.g. by direct payment
    Knowing amount of money in the budget
    Agreeing the Care plan which sets out:
    • health needs / outcomes,
    • 43. money in budget
    • 44. What goods and services will be bought and the cost of these
    Monitoring
    and
    Review
  • 45. Individual Empowerment in Kent
    Different ways of delivering a personal health budget
    Notional individual budget
    Already legallypossible
    Personal care
    plans
    More direct control to individuals
    Real budget held on the individual’s behalf
    Direct payment – cash held by patient
  • 46. Individual Empowerment in Kent
    What can a budget be spent on?
    • Not emergency care or core GP services
    • 47. Agreed care plan with agreed health and wellbeing objectives
    • 48. Services should be appropriate for the state to provide – not gambling, debt repayment, alcohol, tobacco
  • Individual Empowerment in Kent
    Six principles
    • Upholding NHS values
    • 49. Quality is key!
    • 50. Tackling inequalities and protecting equality
    • 51. Personal health budgets are voluntary
    • 52. Decision making close to the individual
    • 53. Partnership
  • Individual Empowerment in Kent
    Local key deliverables
    NHS Eastern and Coastal Kent to pilot:
    • Continuing Health Care with 20 patients
    • 54. End of Life Care with 4 patients
    • 55. Maternity with 30 women
    • 56. Carers
    • 57. Mental Health with 20 individuals
    • 58. Testing the potential of Kent Card
  • Individual Empowerment in Kent
    Local key deliverables
    To build on the integrated commissioning structures between Health and Social Care, KCC has been supporting NHS Eastern and Coastal Kent and will test the potential of the Kent Card as the payment mechanism for the Personal Health Budget
  • 59. Individual Empowerment in Kent
    Why are Personal Health Budgets Important?
    • Increasing satisfaction with services
    • 60. Increasing health outcomes
    • 61. Integration of health and social care
    • 62. System efficiency and costs
  • Individual Empowerment in Kent
    Evaluation of the pilot
    The independent evaluation team in place will
    report at intervals over 3 years, to include:
    Health, wellbeing, experience and access
    Variation by condition and background
    Financial impact
    Effect on NHS services
    Practical – what works, what doesn’t?
    Impact on staff
  • 63. Individual Empowerment in Kent
    Programme timeline
    Summer 2010First interim report published
    March 2010Regulation in place
    2012End of pilots and evaluation
    Mid-2010Direct payments allowed in pilots (subject to regulation)
    April 2010Recruitment to evaluation cohort starts
  • 64. Individual Empowerment in Kent
    Key Challenges
    • Delivering Personal Health Budgets in a time of financial challenge
    • 65. Embedding Personal Health Budgets at the heart of the NHS
    • 66. Supporting cultural change
  • Individual Empowerment in Kent
    The Future of Personal Health Budgets
    • Big Society
    • 67. One of a number of different forms of personalisation being explored across the welfare state
    • 68. Future link all publicly funded support
    • 69. Integration and joint processes
    • 70. Giving people choice an control should be a way of driving up quality
  • Some potential examples of things that can be included
    • Equipment - electric wheelchairs, beds etc
    • 71. Hydrotherapy
    • 72. Complimentary therapy e.g. acupuncture
    • 73. Air conditioning
    • 74. Activities and classes instead of traditional mental health services
    • 75. Alternative respite arrangements
    Individual Empowerment in Kent
  • 76. Individual Empowerment in Kent
    Case Study:
    How Personal Health Budgets work in Kent
  • 77. Individual Empowerment in Kent
    Keys Lessons So Far
    • It takes Time
    • 78. Cultural Shift
    • 79. Support Systems are Essential
    • 80. Development of Provider Market
    • 81. Partnership Working
  • Individual Empowerment in Kent
    Realising potential of Personalisation means:
    Better use of existing resources,
    Improved communication and partnership working between professionals, users and carers, and across agencies, and
    More flexible services focused on
    the needs and priorities of service
    users and carers.
  • 82. Individual Empowerment in Kent