Personal health budgets for children and young people: lessons learnt

Sue Turner, National Development Team for Inclusion (NDTi)
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To coincide with Learning Disability Week 2017 and NHS England’s conference, Sue Turner sets out some of the learning from three sites who have been implementing Personal Health Budgets (PHBs) for children and young people with complex needs.

The National Development Team for Inclusion (NDTi) has worked with Plymouth, Hampshire and Derbyshire to find out about the barriers and potential solutions to successful implementation of Personal Health Budgets. Here are some bitesize insights taken from the full report and top tips

  • The introduction of good personal health budgets requires ‘whole system change'. In this instance we include our education sector colleagues so that planning around PHBs, Education Plans and Health and Care Plans are brought together. When this happened in Plymouth it led to ‘different conversations’ and thus a better way of working. However, this is the exception rather than the norm, and it can be difficult to achieve clear, joined up leadership against a backdrop of continual organisational change.
  • It is not just about statutory services. Partnership working with the voluntary and third sector are also important, both in terms of support planning, and the development of creative, community based support options.
  • People need to develop a joint understanding of ‘strength-based assessment and support planning’ in other words an assessment and planning that looks at a person’s strengths and what they are able to do, rather than their weaknesses. But professionals didn’t always turn up to training or planning meetings. No doubt they were extremely busy, but this resulted in wasted time, miscommunication and poor relationships with families.
  • Families and the child/young person should be at the centre of the process. Investing in and listening to families, and ensuring they have the right information is crucial, but this did not always happen, leading to confusion and disengagement from the project. Peer support networks can be very helpful in these circumstances, as often the best people to talk to families are other families.

Glenys Newman, a personal health budget advisor who was interviewed for this project says:

“I manage to put people at ease and for them, knowing that I also manage my own Personal Health Budget for my daughter who has complex needs can be reassuring as I have first-hand experience of the challenges they can face.”

Sites worked hard to address these issues, and it will be important for other areas to learn from them as the implementation of PHBs continues.  It is particularly important to keep listening to people with learning disabilities and their families.

One of our associates, Sam Sly, sums this up well:

“Remember the answers to a good life are in the detail. You just have to listen to those who know.”



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