Over five million patients in England could be given a personal combined health and social care budget by 2018, paid for by billions of pounds provided by the NHS and local councils.

That is the ambitious plan being laid today at the Conference of the Local Government Association’s conference in Bournemouth by Simon Stevens, NHS England's chief executive. He is launching an Integrated Personal Commissioning (IPC) programme, which will for the first time blend comprehensive health and social care funding for individuals, and allow them to direct how it is used.

The NHS notes that four groups of “high-need individuals” are likely to be included in the first wave from next April 2015, although councils, voluntary organisations, and NHS clinical commissioning groups may also propose others. These are people with long term conditions, including frail elderly people at risk of care home admission, children with complex needs, people with learning disabilities and those with severe and enduring mental health problems.

Under the IPC programme, a combined NHS and social care funding endowment will be created based on each individual's annual care needs, with cash from local authorities and NHS commissioners. Individuals enrolled in the programme will be able to decide how much personal control to assume over how services are commissioned and arranged on their behalf.

Some patients' budgets will be as little as a few hundred pounds, Mr Stevens told The Guardian, though most are likely to get more than £1,000, with a small number who have very complex needs receiving much more. The NHS notes that voluntary and ‘third-sector organisations’ will be commissioned locally to help individuals enrolled in the IPC programme, stressing that “care will in all cases remain free at the point of use”.
Mr Stevens said patients, service users and carers “have the biggest interest in getting things right, but they can only do so if we give them real power to shape their own care”. He added that  “if Beveridge was alive today he'd clock the fact that - given half a chance - people themselves can be the best 'integrators' of the health and social care they are offered”.
The NHS chief went on to say that “we need to stop treating people as a collection of health problems or treatments. We need to treat to them as individuals whose needs and preferences should be seen in the round and whose choices shape services, not the other way round”.

He concluded by saying “that's the big offer the NHS increasingly has to make to our fellow citizens, to local authorities, and to voluntary organisations. We need a double N in 'NHS' - a National Health Service offering more Neighbourhood health support."

NHS England will now work with partners in local government, CCGs, patient groups and the voluntary sector to develop an IPC prospectus which will be published at the end of July. This will formally invite local expressions of interest to participate in the programme from April 2015.