Government plans to hand National Health Service patients more power over their own care have shifted up a gear with the launch of personal health budget pilot schemes - testing direct payments - across England.

Eight pilot projects will see primary care trusts give patients with conditions such as stroke or diabetes direct payments to enable them to make their own decisions on how, when and where they receive their healthcare.

This differs markedly from previous personal health budgets, which could only be held by the PCT or another third party. The Department of Health confirmed that more trusts will be authorised to offer direct payments over the coming year, to help “inform decisions around how to proceed with wider, more general roll-out”.

Under the scheme, patients will be able to use their personal budgets in various ways, with a view to ultimately creating a much more personalised health service. For example, chronic pain suffers might choose alternative methods of pain relief – such as massage or hydrotherapy - over pharmaceutical intervention, the DH explained.

“This is an important step towards putting patients at the heart of everything the NHS does,” said care services minister Paul Burstow. “Direct payments have real potential to improve the lives of individuals with long-term health needs by putting treatment choices in their hands”.

However, earlier this year the British Medical Association said giving patients their own cash pots to pay directly for national health services could potentially “undermine some of the fundamental principles of the NHS and their very existence appears at odds with the workings of the system”.

It argues that while enabling patients to better meet their own healthcare needs could well foster a more equitable health service, the scheme could also open up yet another pathway by which patients could be given different levels of care, “raising significant equity concerns”.