Early learning from Personal Health Budgets

For those of you so inclined, this makes for fascinating reading:

Personal health budget pilot sites have faced early challenges in funding personalised care packages for patients, a national evaluation has found. Pilot leads in primary care trusts said they were struggling both to calculate the value of budgets and to find money to resource them.

The key issues in introducing Personal Budgets in health seem to be:

• PCTs can't calculate the value of budgets - some try to calculate a unit cost from existing contracts, others take an outcomes-based approach, and others just guess
• PCTs can't find the (additional) resources to fund such budgets, since they can't extract this money from block contracts
• Choice and control for patients doesn't seem to have followed where the Personal Health Budget leads.

Now, these are early findings, but they are very interesting indeed. The main reason is that they show just how difficult it is to move from block contract provision to something more flexible and personalised, and to ensure the money follows this move.

It confirms that the main relationship in health commissioning remains between supplier and commissioner, rather than supplier and customer, and is not something I would envisage the Health White Paper (on which more here and here) will overcome.