More than 4,000 people share their experiences of personal budgets

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In Control, Lancaster University and Think Local Act Personal have today published the Third National Personal Budget Survey with the experiences of more than 4,000 people with personal budgets and their carers. The report, focuses on the use of personal budgets in adult social services and health across England and is the largest survey to date looking at the impact that personal budgets are having on people's lives.

More than 80 per cent of people surveyed said that a personal budget had made things better or a lot better when it came to dignity in support and quality of life. At least two thirds also said their personal budget had made things better or a lot better when it came to independence, arranging support, mental health, control over their life, feeling safe, relationships with family and people paid to support them, friendships and self-esteem.

More than two thirds of carers also said that as a result of the person they care for having a personal budget things had got better or a lot better when it came to remaining well and being able to continue caring as well as quality of life for them and the person being cared for.

One of the most important findings was the very clear link between people's experience of the process and the difference the personal budget made to people's lives. Those that found the process of getting and managing a personal budget easy were nearly three times more likely to report good outcomes. Those that said their views were included in the process were nearly twice as likely to report good outcomes. People were also more likely to report good outcomes if they had help to plan their support and if they knew how much money was in their budget.

Interestingly the findings also show that people who used their budget for personal assistants and community-based support rather than more 'traditional services' reported their personal budget making a bigger difference to their lives.

Age or social care group seemed to make little difference to how well the personal budget worked for people, nor did whether their personal budget was held as a direct payment, an individual service fund or managed by the council.

Writing in the report's foreword, Minister of State for Care and Support, Norman Lamb MP, said: "We must strive to improve the outcomes people experience as a result of using personal budgets not just focus on increasing the numbers. We should always be asking 'are people getting better lives and support - and is the experience simpler and more flexible?"

Commenting on the findings, Julie Stansfield, In Control's chief executive said: "When used to their potential personal budgets are an important tool enabling people to get control over their lives. We have now moved on from questioning whether they have a role to play in public services, they are a clear part of the future of social services, education and health for people of all ages, but the question now is what can we do to make them work for people in the best possible way? This report gives us the clearest indication to date on what's working and what's not in their delivery and provides a very useful insight for councils and health organisations on where they need to focus their efforts.

"A survey of 4,000 people is a significant number and critically this survey is based on people's direct reported experiences representing what it the reality for people. The positive difference that personal budgets are making to people's lives irrespective of their age or social care group is encouraging but it is very clear from the survey that these differences are only achieved when the control shifts from services to the individual.

"However this is the third national personal budget survey we have published with TLAP and it is disappointing to see yet again such wide variations in delivery and process. There is much more that can be done to improve delivery, in particular reducing bureaucracy. Councils and health organisations to need to learn from each other and make greater use of best practice."

Think Local Act Personal Director Sam Bennett said: "TLAP welcomes these findings and will continue to work with our partners and others to address the challenges of uneven delivery and the continuing experience of frustrating and unhelpful process. Over the next 12 months we will add to and share our understanding of what works best to deliver the very best results for people. It is particular important to learn the lessons of introducing personal budgets in social care to ensure partners in health and education provide the very best opportunity of making personal health budgets and Education Healthcare Plans improve the lives of people with long term health conditions and young people with special educational needs."

TLAP Co-chairs & National Co-production Advisory Group members Marjory Broughton and Clenton Farquharson, said: "This results from this survey is a powerful reminder of the reasons why we are undertaking the challenging task of mainstreaming delivery of personal budgets- to improve the experiences of people wishing to live their lives in the way that works best for them, their families and carers. There is much to learn about how we can make things better for everyone. We hope practitioners will read this report and act on its findings."

The report is based on the Personal Outcomes Evaluation Tool (POET) which has been developed by In Control and Lancaster University over the past 10 years as a way to measure what's working and what's not when it comes to personal budgets and personalised care and support. It was originally for use in adult social care but has now been developed for use in health, children's services and education. A version for providers is also in development.

Personal health budgets

For the second year, the survey has included people with personal health budgets, whose support is funded by the NHS. Since 1 October 2014 people receiving continuing care (including children) have the right to have a personal health budget. Altogether 129 personal health budget holders and 101 carers completed the survey, with 22 of 211 CCGs taking part. Over 70% of people taking part said that they received their budget as a direct payment.

POET provides an easy way for CCGs to find out how personal health budgets are working for people and families. NHS England has made it available at no cost to all CCGs.

Once again the results look very positive - with 86% of people reporting improved quality of life, and fewer than 6% reporting any negative outcomes.

Luke Oshea, Head of Integrated Personal Commissioning & Person Centred Care at NHS England said: "I really welcome the latest POET survey. It's great to see such good results, with over 80% of people taking up personal health budgets reporting improved quality of life. However there is still room to make personal health budgets easier. Over one in five people said that some aspects of the process were made too difficult.

"The NHS Forward View published last week calls for an increase the direct control patients have over the care that is provided to them. As part of this, the new Integrated Personal Commissioning programme will provide an integrated budget that will be managed by people themselves, or on their behalf by councils, the NHS or a voluntary organisation. The good progress already being made on introducing personal health budgets provides an essential building block for the new approach."