National Health Service patients with long-term conditions are a step closer to getting access to personalised healthcare budgets, after projects across the country were awarded provisional pilot status.

The DH received a total of 74 applications to run pilot schemes for personal budgets, 65 of which, involving 75 primary care trusts, were selected following a “robust assessment. According to Health Minister Lord Darzi, the level of interest in the scheme shows “real enthusiasm and energy across health and social care for this agenda”.

Personal budgets have been available in social care since the mid-1990s, and their extension to health has long been called for to give patients with long-term conditions such as diabetes and multiple sclerosis more control and responsibility over their own care.

The aim of personal budgets is to give patients more involvement in how money is spent on their healthcare, so that they have more of a say in which services and which service providers they use, thereby tailoring care to their own needs.

According to Lord Darzi, who included personal health budgets in his High Quality Care for All report last year, the key aim of personal health budgets is to encourage the cultural shift needed for a more personalised NHS, and he claims they have “the potential to improve the quality of patient experience and the effectiveness of care by giving individuals as much control over their healthcare as is appropriate for them”.

Three-tiered policy
The DH envisages three different types of personal budgets: notional personal budgets, under which the NHS underwrites overall costs but patients are aware of the treatment options within a budget constraint; real personal budgets held by the system, under which patients are assigned a budget held on their behalf by a ‘middle man’ such as a GP or care co-ordinator who helps the patient select services; and direct cash payments to patients so that they can buy and manage services themselves.

Pilots schemes across the country are currently centred those personal health budgets where the patient does not hold the budget, which is held by the PCT of a third party on their behalf instead. But subject to a parliamentary green light for the draft provisions set out in the Health Bill for direct payments to patients for healthcare, some of these sites will also then start piloting that mechanism of personal budget delivery, the DH said.