NHS professionals wary of personal health budgets - mental health

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NHS professionals wary of personal health budgets

Released 25/03/2011

Confed report calls for an evidence base to be built before full implementation

Frontline health professionals support the idea of personal health budgets, but currently have little enthusiasm for their implementation, according to a report from the NHS Confederation's Mental Health Network and the National Mental Health Development Unit.

The report is based on a survey of over 600 social care workers, psychiatrists, psychologists and community psychiatric nurses, not currently involved in the personal budget pilot programme, and backed up by 60 in-depth interviews. It says clinicians especially are not yet convinced that personal health budgets will benefit patients.

Fifty one per cent of healthcare professionals agree that personal budgets will enable a positive shift in power and control to service users, whereas only 20% disagree.

Overall, however, just 28% of respondents said they have any enthusiasm for personal health budgets to be implemented.

Concerns centre around two main issues:

An absence of evidence that patient choice delivered through personal health budgets will improve health outcomes. This is a particular concern for doctors - 53% of GPs cited lack of an evidence base as the major barrier to implementation.

By reducing face-to-face time with patients, the bureaucracy involved in planning and administering personal health budgets could outweigh any potential benefits. This is a particular concern for frontline professionals who already have experience of personal budgets in social care.

The government is currently piloting personal health budgets and has given strong support for a roll-out of personal health budgets starting in 2012.

The report recommends that professionals be involved more actively through a wide-scale programme of workshops and learning events across the country.

Given this momentum, the report nevertheless makes it clear how vital it is to address the concerns of clinicians and scale up the level of engagement with NHS staff or personal health budgets run the serious risk of not succeeding.

Even more than in social care, `buy in' from healthcare professionals is vital because their training and clinical expertise means they can only recommend treatment and support that is backed up by evidence.

The NHS Confederation believes that the current academic evaluation of personal health budgets should continue long enough to provide evidence of their real impact on patient outcomes and experience - before a national roll-out is considered.

NHS Confederation Mental Health Network director, Steve Shrubb said: "Our findings show there is widespread support for the concept of personal budgets among mental healthcare professionals. They recognise that empowering people to take control of the money spent on their care can be vital to recovery.

"What we cannot get around is that, while supportive of the idea of personal budgets, clinical staff are extremely worried that choice through personal budgets may not be backed up by sufficient evidence.

"The history of reform in the NHS is littered with good ideas that have failed as the evidence base had to catch up with implementation or staff were not engaged."