Sam Bennett >> Hi, I’m Sam Bennett, I’m head of Integrated Personal Commissioning
and Personal Health Budgets at NHS England, responsible for both the policy and strategy
development and the delivery programme for personal health budgets, and it’s expansion
across all CCGs in England, and also heading up the Integrated Personal Commissioning Programme,
and supporting the nine demonstrator sites over the next three years.
We’ve focussed IPC on those people that get the worst experience of health and care
at the moment, by virtue of the complexity of their needs, and the number of different
services that they need to engage with to be able to live a good life. So we’ve focussed
on people with learning disabilities, particularly those with behaviour that challenges traditional
services, with people with severe and enduring mental health problems, older people with
multiple long term conditions, and importantly also this is an adults and children’s agenda,
so we’re focussing on children with complex needs as well.
The overall purpose of the programme is to improve their quality of life, to better integrate
health and social care services, and education where that’s appropriate, around the needs
of the individual, and to improve their experience of care, and reduce unplanned hospital admissions,
and inappropriate placements in institutional settings where that’s avoidable.
We would describe five key shifts that are central to what we’re trying to deliver
through IPC. The first of those is that it’s a targeted approach that improves people’s
experience of care and prevents crises where that’s, where that’s possible. It is a
targeted approach, sites have identified specific cohorts of people that they think would benefit
from a very different, very bespoke, very personalised experience of care, and are approaching
those people with a clear offer of a different conversation, that’s the second shift that
we want to see is a very different conversation for people with the clinicians and the other
professionals involved in their care, which is less about fixing them, or looking at just
medical needs, and more about how we develop a holistic plan for people’s health and
wellbeing needs, that responds to what’s important to them as well as what’s important
for them. A big part of that, and the third shift, is a real strong community and peer
focus, through that planning conversation, so we’re not assuming that statutory services
are the answer. We’re working proactively to link people into community based resources
and to strengthen their connections to their community, and we’re putting them in touch
with peers, who have lived experience that can help strengthen their capacity to self-manage.
This is about building people’s skills, knowledge and confidence to be able to manage
their condition better, with the support of the services that they need.
The fourth key shift is to enable people and their families to take direct control over
the resources available for their care. This is the bit about extending personal budgets,
both personal budgets that are funded through the NHS, through social care, and integrated
personal budgets where people’s needs require funding from different sources, so one of
the offers that will be made through the planning conversation is for all or part of the money
that’s available to support someone to live a good life to be taken as a personal budget.
And the final shift, is we would want people to be able to have a wider range of options
for how they use that resource, that is truly tailored to their needs and preferences, so
rather than just linking people into a generic set of service options, we’re looking to
design services around people’s individual needs and requirements, and develop a broader
range of service options that people can choose from, in that.
Sam >> IPC is one of a range of different integration programmes happening across the
NHS and social care at the moment. It’s the only one however that really focusses
in on how we integrate health and care around the individual, at a level where services
are able to respond to their particular needs and preferences, and the budgetary integration
we’d see through IPC is about blending resources from across health, social care, and other
areas, education, where that’s appropriate, at an individual level through personal budgets,
so wider integration programmes have tended to focus at system level, or at macro, sort
of budgetary integration, and this is very much taking that down to the individual level,
and designing care from the bottom up around their individual needs and preferences.
James >> I’m James Sanderson, I’m the Director of Personalisation and Choice at
NHS England, erm we’re providing support through regional representatives, assigned
to each site, that are able to provide knowledge and experience. We have a number of specialists
who are able to unlock key components of IPC, such as information and governance, such as
finance, such as person centred planning. I want to see that personalisation and choice
become default settings within the health service. There’s a lot of work to do in
that area, but there’s a lot of exciting possibilities as well that that brings. There
needs to be a shift, from a paternalistic healthcare system to one that actually involves
the patient at the centre, and enables the individual to structure care around their
needs, because there’s proven evidence that that can greatly assist the achievement of
better health outcomes. There’s multiple factors involved in making
IPC and personal health budgets a success, the key factor I think is really, an active
partnership. All of the providers have got to work together, CCGs, providers, local authorities,
NHS England, and the voluntary sector, and people themselves. This needs to also have
an element of co-production, peer leadership is incredibly important here. And if we bring
all partners together as we have done in the recent IPC residential, it enables us to use
the strength of those numbers, and the influence that those people have, in order to create
a really really healthy and productive programme.