In response to press reports concerning the use of Personal Health Budgets, Disability Rights UK calls for greater investment in support for those with long term health conditions, not less
The majority of users of the NHS are people living with long-term conditions, like dementia, diabetes and Parkinsonism. The Department of Health found they are huge users of health care resources, accounting for at least 50 per cent of all GP appointments, 64 per cent of outpatient appointments and 70 per cent of all inpatient bed days (Department of Health 2012). The Kings Fund found that more than 15 million people have a long-term condition for which there is no cure (Kings Fund 2013).
Yet our NHS has been designed far more around people with short-term acute needs – a one-off operation, or an infection that the GP can treat. The Kings Fund argues that the most important challenge facing the NHS is to improve the treatment and management of long-term conditions, requiring a shift away from reactive, disease-focused, fragmented care towards a more proactive, holistic and preventive approach, in which people with long-term conditions are encouraged to play a central role in managing their own care.
And we, as an organisation led by people living with impairments or health conditions, have shown how this can be done – by pioneering personalised plans, support and peer support, so people have most choice and control over how to live their own lives. Our Get Yourself Active Project seeks to increase the number of disabled people playing sport or accessing sporting opportunities by using their personal budgets.
Personal health budgets do something critically important. They offer a way forward for people with long-term conditions: a personal plan to enable them to manage their own condition and their life. People need different things to live with their condition: for instance, for someone with severe depression, a break can stop them from needing to go into hospital, providing an ongoing viable plan that they have chosen and can manage. The state invests some money – and the individual is better able to manage their condition and their life, with all sorts of social and economic benefits: they may be better able to raise their children, less likely to go into hospital. Overall – for just such reasons – evaluation of personal health budgets has shown that this imaginative approach is cost effective (Dept of Health 2012a). This is a good use of public money.
We encourage clinicians to get involved in this vital transformation (as many are already doing) and help create empowering support for millions of people - rather than criticising it.
References:
Dept of Health (2012). Long Term Conditions Compendium of Information, 3rd ed. London: Department of Health
Kings Fund (2013) Delivering better services for people with long-term conditions
Dept of Health (2012a) Evaluation of the personal health budget pilot programme