Health: The big bonuses of personal health budgets

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NHS cash will soon be available for unusual purposes, says Lisa Salmon.

Getting away from it all by the seaside, going for a long walk with the dog and singing have long been seen as wonderful for wellbeing, but hardly medicinal.

That’s until now – as in a few month’s time, some long-term sick and disabled people will be entitled to ask the NHS for money allocated to their ongoing care to be spent on improving their health in the way they see fit.

With input from experts, patients could choose to spend the money in these ‘personal health budgets’ on anything from traditional care, to buying a dog for companionship and exercise, singing classes to help improve breathing problems, or even booking a quiet break away.

“The idea is that you can do anything with it that meets your health needs,” says Vidhya Alakeson, mental health lead for NHS England’s personal health budgets delivery programme.

“You identify what your health goals are, and how you might meet them.

“The guidelines have very few restrictions, so anything that’s legal and isn’t alcohol, cigarettes or whatever is allowed.”

Alakeson also stresses that those entitled to their own budgets will still use their GP, be prescribed medicines and be admitted to hospital as normal.

“It’s really important that people understand this is not saying we’re going to take all the money we would have spent on you in the NHS and tell you to get lost and sort it out for yourself.

“Personal health budgets are just the money that’s spent on people’s ongoing needs.”

Pilot schemes of the budgets ran throughout the country from 2009 to 2012, and with very positive results.

Successful examples include people with mental health conditions, who in the past had ended up in hospital, using their budgets to stay in B&B accommodation.

“What they need is a place to go to when they’re feeling distressed, where they’ve got an agreement with a B&B owner and can have quiet and maybe walk on the beach, instead of using a hospital inpatient bed,” explains Alakeson.

“It’s much cheaper, and because people with mental health problems often don’t really want to be in hospital, the outcomes tend to be better too.”

People can also use the money to join a gym or buy exercise equipment, like a man with motor neurone disease who bought an adapted bike to help him remain active and slow his deterioration.

Amid all the clear strengths, there is one negative - namely the fear that people may abuse the money.

But Alakeson is keen to point out the pilot schemes proved no need for such concerns, partly because there are many checks such as a requirement for receipts.

“People get this money because they have a condition that needs to be managed, and they have a strong incentive to use it well,” Alakeson argues.

“Rather than frivolous expenditure, what you see is that people are much more prudent with the money than the system is, as they have a vested interest in spending it well, and often feel quite grateful for the opportunity to do something different with it.”

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