Making personal health budgets work for people with learning disabilities - new advice

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Personal health budgets have been found to work best for people with the highest needs and can help join up health and social care at the level of the individual. A new report which was commissioned by TLAP focuses on personal health budgets for people with learning disabilities and autism.

The report, "Personal Health Budgets: including people with learning disabilities" shows that when people and their families get the chance to write their own individual plan and have control over the money available for their support, it can lead to better support for individuals who may otherwise end up in high cost, poor quality residential services.

From April this year all Clinical Commissioning Groups will need to be able to offer personal health budgets, initially to people who are eligible for NHS Continuing Healthcare (NHS CHC) funding and others with long term conditions.

The report, which can be used as a resource, contains examples from around England of NHS CHC teams and people from specialist learning disability services working together to better integrate health and care support for individuals. There are also case studies of people experiencing the benefits of receiving a personal health budget or joint health and social care budget.

The report recommends that personal health budgets could and should be offered routinely to:

  • Young disabled people who are moving towards adult life
  • People being moved from unsuitable placements as part of the Winterbourne View action plan
  • Other people with learning disabilities or autism who have high support needs and are not well served by conventional service approaches.

Two and a half years after the Winterbourne View scandal, 3200 people with learning disabilities and autism are still in hospital settings- over 60% for more than one year and, unbelievably, 20% for over five years. It doesn't have to be like this as Jason's story illustrates. As the Joint Improvement Programme seeks to give more urgency for a permanent discharge programme, this publication is both timely and welcome. Personal health budgets provide an important catalyst for more flexible and creative solutions for people with complex needs- people who nonetheless want a better life.

Bill Mumford, programme director for the Winterbourne View Joint Improvement Programme.

People with learning disabilities and their families can really benefit from a personalised approach and as this guide clearly shows this includes personal health budgets, even for those with the most complex support needs. People should not be excluded simply because they have a learning disability.

Commissioners and providers will find this guide a valuable resource as they consider how to implement personal health budgets locally for people with learning disabilities.

Dominic Slowie National Clinical Director for Learning Disabilities.

This report makes a useful contribution to the overall thrust to improve understanding and practice of integrated working between health and social care; so important in ensuring that people with learning disabilities have the widest range of support options possible. The upfront allocation of the money available for people's support is crucial to this, but if managing the cash themselves is not what people choose to do, arrangements such as individual service funds are a way to maintain enhanced choice and control of their support through a chosen provider.

Bridget Warr, Chief Executive of United Kingdom Home Care Association and chair of Think Local Act Personal's work on integrated budgets.