Phbs children_17.1.14 final


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Phbs children_17.1.14 final

  1. 1. Implementing personal health budgets for children with continuing healthcare Julie Stansfield, Sue Bottomley and Michael Chew 17th January 2014
  2. 2. How to participate today
  3. 3. 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
  4. 4. Agenda • National overview and context • NHSE programme & priorities • Implementation on a local level – The Wigan experience • Wider support available to CCGs & councils • Questions
  5. 5. Julie Stansfield: National update & context Spending review NHS White Paper SEND Green Paper 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 2014 This was followed up by an announcement of a “right to have” and from 2015 extension to other long term health needs who would benefit. Carers’ strategy NHS Future Forum and the Government’s response To edit footer go to: View> Header and Footer Right to Control NHS Operating Framework.
  6. 6. What is a personal health budget? 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.
  7. 7. 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 Right to Control pilots Self-directed support Personal health budgets Special Educational Needs & Disabilities (SEND) pilots Choice, including choice of provider, GP, treatment and Choose & Book Personal budgets in social care
  8. 8. 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
  9. 9. Different ways of delivering a personal health budget Personal care plans Real budget held on the individual’s behalf Direct payment – cash held by patient From Aug 2013 More direct control to individuals Notional individual budget
  10. 10. 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)
  11. 11. 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
  12. 12. 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
  13. 13. SEN:D Pathfinder and Personalisation in Wigan Michael Chew Assistant Director: Children’s Commissioning Wigan LA/Wigan Borough Clinical Commissioning Group
  14. 14. 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
  15. 15. Wigan Context • • • • • • Integrated commissioning model Integrated care Partnership Care in the community (CHC) Aiming High legacy (Direct Payments) Special Schools review
  16. 16. 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
  17. 17. 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
  18. 18. 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)
  19. 19. Summary • • • • • Improved the patient experience Increased choice, control, empowerment Personalisation not just PHB Key contribution from NHS workforce Requires whole system change
  20. 20. Wider support available • Health and Children’s programmes: – Build on national support available – Practical, on-site support – Membership community – Bespoke support available
  21. 21. Any questions?
  22. 22. Further information and contact details