Presentation from Nicola Kay, Deputy Director with responsibility for policy and strategy within Personalised Care, NHS England.
Minutes:
The Chair welcomed Nicola Kay, NHS England’s Deputy Director with responsibility for policy and strategy within Personalised Care, to the meeting.
Nicola outlined the work that had been taking place on developing and rolling out a new comprehensive model for personalised care across the NHS. She said that the commitment to personalised care was laid out clearly in the NHS Long Term Plan: (“People will get more control over their own health, and more personalised care when they need it”) and there was a target to reach 2.5 million people by 2023/24 and 5 million by 2028/29.
Nicola went on to explain some of the other commitments in the Plan that depend on personalised care including supporting care quality and outcomes for patients with dementia and cancer; supporting greater choice and control for people with learning disabilities, autism, children and young people and people with mental health conditions; and expanding supported self-management for people with long-term conditionssuch as diabetes, respiratory disease and muscular skeletal conditions.
Nicola concluded her presentation by talking about the publication “Universal Personalised Care”, which is the delivery plan for personalised care, and sets out 21 detailed actions to achieve the implementation of the Comprehensive Model for Personalised Care.
In the discussion that followed, the following comments and questions were raised by members:
· How personalised could personalised health budgets be? What were the rules and regulations surrounding their use? Nicola explained that there was considerable flexibility and no misuse of the budgets had been found so far. She stated that there were approximately 50,000 personalised budgets at the moment, mainly in continuing health care, and the money was spent on a variety of things such as carers, PAs, assistive technology and assistance dogs.
· How much local determination could there be? Nicola said that it was a difficult balancing act – giving local areas the autonomy to respond to specific issues but maintaining uniform standards across the country.
· There should be a legal right to have a personalised budget in home-based Continuing Health Care (CHC) – this should be the default position. Concern was expressed that there was variability of take up of CHC around the country. Nicola said that she wasn’t aware of this but would look into it.
· In relation to the new Social Prescribing Link Worker roles, concern was expressed that some of the existing excellent practice may be lost. Nicola gave reassurance that they wanted to build on what is already there and not throw the baby out with the bathwater.
· Concern was expressed that some residents still had to fight to get personalised payments, for example, for things like gym membership. Nicola said that this shouldn’t be the case as attending a gym could really benefit some people with long term conditions.
· It was stated that ward councillors already acted as unofficial link workers in their communities and much more use should be made of them, particularly where there was a lack of capacity in the system. Nicola agreed to ask local NHS bodies to work more closely with local ward councillors as well as council’s themselves.
· Were the NHS personalised budgets being integrated with existing social care personal budgets? Nicola said that Integrated Personal Budgets were already in place but there were barriers to further integration which could require changes to regulations.
· What happened when individual budgets didn’t get spent and people chose to save the money instead? Nicola said that they all undergo an auditing process so this would be picked up.
· Concern was expressed about the capacity of the Community & Voluntary Sector (CVS) to support the social prescribing process. Nicola said that the CVS needed very much to be part of the process and the NHS was trying very hard to work with organisations locally.
· How was the NHS working with councils to ensure that people were not having to wait long periods of time to get personalised budgets? Nicola said that the process of getting a personalised budget could be difficult but they were trying to put standards in place around the timing of processes. She admitted that this could improve and that some areas of the country were better than others.
The Chair thanked Nicola for her presentation and for answering the Board’s questions. Nicola said that she would be happy to come back and speak to the Board again in the future.
Decision
Members of the Community Wellbeing Board noted the update.