Leading healthcare organisations have called for a demonstration project or pilot to be set up to test the effectiveness of personal health budgets (PHBs) for long-term mental health service users.
The call, from policy makers for the Department of Health, mental health service providers, clinicians and representatives of third sector organisations, came at a roundtable event organised by think-tank the Centre for Social Justice and service provider Partnerships in Care.
At the roundtable, delegates reviewed research and experience relating to personalisation and shared successful patient outcome case studies from innovative and less traditional care and treatment pathways such as the Leeds Crisis House, which accommodates people in crisis at a price below the cost of an NHS inpatient bed.
Speaker Kevin Lewis, director of Kevin Lewis Consulting, and former programme director: personalisation at the National Mental Health Development Unit, laid out the case for personalisation as re-framing the relationship between service users and providers and increasing choice and control. He also outlined the potential for PHBs and direct payments to help move away from traditional methods of care towards more innovative types of service.
Lewis shared patient case studies including:
• 17 out of 20 patients improved mental health after PHB gave them faster access to cognitive behavioural therapy in a Kent PHB pilot
• A London patient at highest risk of self-harm during night hours used direct payments to buy out of hours support
• Patients may use PHB to choose their own community psychiatric nurse
• A service user who found trips to the beach particularly therapeutic is using direct payments for travel and accommodation expenses.
In discussion, delegates agreed that the real challenge in PHB is offering patients services other than traditional ones. Developing new services at the acute end of need is beyond the capacity of single budget holders – leading to delegates’ unanimous agreement that innovative new services that can be funded by PHBs need to be crafted and demonstrated in pilots that can lead to real innovation.
Speaker Dr Rachel Perkins OBE, former director of quality assurance and user experience at South West London and St George's Mental Health NHS Trust, called for some of the NHS’ £20 billion savings related to ward closures to be channelled to fund PHBs and innovative services.
Delegates from Oxleas NHS Foundation Trust, Central and Northwest London NHS Foundation Trust and South London & Maudsley NHS Foundation Trust indicated they would be interested in exploring, in association with external agencies and service providers, pilot projects aimed at long-term mental health service users and harnessing the power of personal budgets.