Agenda Item 4a
Sefton Public Engagement and Consultation Panel Date: 11th February 2016 Title: Proposal to undertake Public Engagement and Consultation Activity –
NHS South Sefton and NHS Southport and Formby CCG Personal Health Budget Engagement
Report of: Tracey Forshaw – Programme Manager Vulnerable People – NHS
South Sefton and NHS Southport and Formby CCG Clare Johnston - Carers Voice Development Officer - Sefton Carers Centre
1. Purpose of the Report 1.1 To receive information with regard to the consultation plans being
developed with regard to the Personal Health Budgets for NHS funded care
2. Background 2.1 The main purpose of the Public Engagement and Consultation Panel is
to coordinate and ensure the quality of public engagement and consultation, in accordance with the standards for engagement and consultation.
3. Personal Health Budgets for NHS funded care 3.1 Following a successful pilot programme by the Department of Health,
which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB.
The Government has confirmed a commitment in the NHS mandate
2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015.
What is a Personal Health Budget (PHB)? PHBs are the allocation of NHS funding which patients, after an
assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people to exercise choice and control over their lives is central to achieving better outcomes for individuals.
For Eligible Persons there is a duty on CCGs to:
• Consider any request for a PHB; Page 1 of 14
• Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs.
There are five essential characteristics of a PHB. The person with the
PHB (or their representative) must:
1. be able to choose the health outcomes they want to achieve 2. know how much money they have for their healthcare and support 3. be enabled to create their own care plan, with support if they want
it 4. be able to choose how their budget is held and managed 5. be able to spend the money in ways and at times that make sense
to them, as agreed in their plan. 3.2 There is a requirement to engage to raise awareness of individuals right
to a personal health budget (PHB), to ensure that there is an understanding of what the offer will mean and to manage expectations in relation to the delivery of PHB’s across the borough of Sefton. To consult and enable feedback on the proposed literature which has been developed to promote and explain PHB’s, which are intended to be available on the CCG’s website from April 2016.
3.3 It is likely that this will have an impact on 3rd sector organisations, social
care colleagues, health practitioners, advocacy services ability to signpost appropriately following request.
4. The Consultation 4.1 The consultation and engagement process will be carried out by Sefton
Carers Centre on behalf of NHS South Sefton and NHS Southport and Formby CCG, following Sefton Carers Centre successful national bid to secure funding to promote PHB’s across the borough of Sefton. The consultation will take place in two phases.
4.2 Phase One Engagement 1st February 2016 – 29th February 2016 Timescale for engagement: The engagement will cover a 4 week
period. Representation of the groups below will be sought from pre-existing groups that meet to support these health conditions.
Method of engagement: Focus groups with a maximum of 10 people
per group Patient representation groups to include:
• Parents of children eligible for Continuing Health Care (CHC). If a child receives CHC, they will have an education, health and care plan (an EHC) plan, or will be transferring to one very soon.
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• Adults eligible for CHC, including individuals with Long term health conditions, Learning disabilities and Mental health conditions.
• Service users in receipt of PHB’s. The engagement process will include residents from both the North and
South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process
Areas to receive feedback on: Individuals will be shown copies of
literature that has been compiled to promote and explain what Personal Health Budgets are. The engagement will seek to address and clarify the understanding of the points below;
• Is there an understanding of what the offer of a PHB means?
Specifically, seeking understanding on what the distinction between the ‘right to ask’ and ‘right to have’ change means in practice, gather expectations of this.
• Assess how well people feel their needs are understood and how well their needs are currently met
• Assess if any individual has been turned down for PHB in the past, what did they ask for and was it explained clearly and understood the reasons for PHB being turned down
• What would be the likeliest use for PHB funding should it be received
• What is felt to be the biggest barrier to accessing the funding • General concerns/reservations from actual or potential PHB budget
holders • Testing of literature for proposed leaflets including a standard leaflet
and an easy read version in addition to proposed website text to receive feedback on if the level of information is sufficient or there are any changes required to be made to address any areas not currently covered/explained sufficiently
The above are the key themes/questions which will be used to shape the
discussions. How the engagement may help to shape future work plans:
• Look to revise proposed literature dependent on feedback from the engagement process if changes are requested to be made
• Managing expectation, working with service users, local residents, NHS workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton.
4.3 Phase 2 engagement process post 1st April 2016 to focus on NHS
professionals across the wider NHS, partner organisations and service users.
Timescale for engagement: The engagement will cover a 4 week
period from 1st April – 30th April 2016 Due to timescales involved, representation of the groups below will be sought from pre-existing groups that meet to support these health conditions.
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Method of engagement: Focus groups with a maximum of 10 people per group and 1:1 interviews with NHS professional to be flexible with work commitments
NHS Professional representation: To engage with a range of NHS
professionals across the wider NHS workforce Patient representation groups to include:
• Parents of children eligible for Continuing Health Care (CHC). If a child receives CHC, they will have an education, health and care plan (an EHC) plan, or will be transferring to one very soon.
• Adults eligible for CHC, including individuals with Long term health conditions, Learning disabilities and Mental health conditions.
• Service users in receipt of PHB’s. Partner organisation engagement: to engage with partner
organisations across the voluntary, community and faith sector to ensure that the local offer of PHB’s is understood and organisations can promote PHB’s locally as an option to service users.
The engagement process will include residents from both the North and
South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process.
How the engagement may help to shape future work plans:
• Look to revise proposed literature dependent on feedback from the engagement process if changes are requested to be made
• Managing expectation, working with service users, local residents, NHS workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton.
5. Recommendations 5.1 The Public Engagement and Consultation Panel is recommended to: a) Appraise the public engagement and consultation plan for Personal
Health Budgets in Sefton b) Request that the officers return to the Panel to provide details of
their feedback and evaluation resulting from the above consultation.
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Public Engagement & Consultation Panel
PROJECT PROPOSAL
Project Title: NHS South Sefton and NHS Southport and Formby CCG Personal Health Budget Engagement
Is your project linked to:
A new service - please attach a new Equalitiess Impact Assessment
Lead officer: Tracey Forshaw Contact no
0151 247 7247
Designation Programme Manager Vulnerable People
E-mail [email protected]
Which of the Council’s Priorities does your Consultation relate to (please tick)
x The Economy
x The Most Vulnerable
x Health and Wellbeing
Reshaping the Council
Resilient Communities
The Environment
Which of the Health and Wellbeing Board’s Priorities does your Consultation relate to (please tick)
Ensure all children have a positive start in life
Support people early to prevent and treat avoidable illnesses and reduce inequalities in health
x Support older people and those with long term conditions and disabilities to remain independent and in their own homes
x Promote positive mental health and wellbeing
Seek to address the wider social, environmental and economic issues that contribute to poor health and wellbeing
Build capacity and resilience to empower and strengthen communities
Does this consultation relate to an item on the Forward Plan? If so which one?
N/A
Other partners involved (please state if internal or external to the Council)
Sefton Carers Centre -External
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(Planned) start date
(Planned) end date:
What is the allocated budget?
01/02/16 30/04/16 £10,000
Background/Rationale Following a successful pilot programme by the Department of Health, which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB. The Government has confirmed a commitment in the NHS mandate 2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015. What is a Personal Health Budget (PHB)? PHBs are the allocation of NHS funding which patients, after an assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people to exercise choice and control over their lives is central to achieving better outcomes for individuals. For Eligible 1Persons there is a duty on CCGs to: • Consider any request for a PHB; • Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs. There are five essential characteristics of a PHB. The person with the PHB (or their representative) must: 1. be able to choose the health outcomes they want to achieve 2. know how much money they have for their healthcare and support 3. be enabled to create their own care plan, with support if they want it 4. be able to choose how their budget is held and managed 5. be able to spend the money in ways and at times that make sense to them, as
agreed in their plan.
Aims & Objectives
1 An eligible person is someone in receipt of NHS Continuing Health Care Page 6 of 14
The purpose of this engagement proposal is to provide a brief overview on how we intend to engage with local residents, establishing their expectations and understanding of Personal Health Budgets to influence local delivery.
Target Audience
Sefton borough wide target audience to include: • Parents of children eligible for NHS Continuing Care (CC). If a child receives
CC, they will have an education, health and care plan (an EHC) plan, or will be transferring to one very soon.
• Adults eligible for NHS Continuing HealthCare (CHC), including individuals with Long term health conditions, Learning disabilities and Mental health conditions.
• Service users in receipt of PHB’s.
Methodology
The consultation and engagement will be undertaken by Sefton Carers Centre, on behalf of and in conjunction with NHS South Sefton and NHS Southport and Formby CCG. There are 2 planned phases. Phase 1 which will commence 1st February to the 29th February which will aim to raise awareness of PHB’s, test and inform proposed literature and to provide clarity in relation to expectation of availability. Focus groups with a maximum of 10 people per group and 1:1 service user face to face/telephone interviews as appropriate. Phase 2 will commence from 1st April to the 30th April, and will look to revise proposed literature dependent on feedback from the engagement process if changes are requested to be made and manage expectation, working with service users, local residents, NHS workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton. Focus groups with a maximum of 10 people per group and 1:1 face to face/telephone interviews with professionals to be flexible with work commitments.
Communications Plan
Key Message Audience Method
Awareness and understanding of Personal Health Budgets locally in Sefton
All as listed above in Phase 1 & 2 methodology
As listed above in methodology
Views and experience of current service users requested to help to inform and potentially influence local delivery of PHB
As above listed under Phase 1 methodology
As above
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Potential barriers to involvement and action to overcome barriers An initial pre consultation and engagement EIA has been completed and its findings will be used to inform the approach used to reduce any potential barriers or inequity with involvement opportunities.
How will you protect the confidentiality of participants?
All activity as listed will be conducted in line and adhering to protections set out in the Data Protection Act, 1998. All information collected is anonymised and information will be stored securely.
How and when do you intend to report or publish the findings?
Phase 1 will be detailed in a report that will be available from 1st March 2016 and can be reported back to this panel, EPEG and through South Sefton & Southport and Formby CCG’s communications. Phase 2 will be detailed in a report that will be available from 1st April 2016 and can be reported back to this Panel, EPEG and through South Sefton & Southport & Formby CCG communications.
Level and type of patient/public engagement (place a tick in all that apply)
Tick Level Description
√ Informing Giving people information about something (a limited opportunity for them to be involved)
√ Consulting Getting people’s views to help you develop/change your services/plans
Deciding together Making decisions using patients’ and public’s views
Acting together
Local people will be involved in making decisions and reviewing your plans/services
Supporting local initiatives
Local people will have the opportunity to lead, develop and deliver activities independently
Does your project include:
Yes/No If No please explain
Questionnaire (Please attach .
Yes Questions used in focus groups/face to face/telephone interviews attached
Other materials (i.e. promotional materials)
Yes Draft patient leaflets
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A stakeholder map (a tool to help you identify your target audience – included in toolkit)
No
Reference to existing data or information that has already been completed (i.e. recent consultation/ research where results can be used to inform your consultation)
No
Any other information you would like to provide?
Attached EIA
If you require further information please contact either Jayne Vincent on 0151 934 3840 or June McGill on 0151 934 4080
Signature of Project Lead: Date: 4th February 2016 Manager Approval: Date: Date approved by Business Intelligence & Performance Team Date Please return this form electronically to:- [email protected] or [email protected]
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Annex 1 NHS South Sefton CCG and NHS Southport and Formby CCG Personal Health Budget Policy Engagement Proposal
History Following a successful pilot programme by the Department of Health, which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB. The Government has confirmed a commitment in the NHS mandate 2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015. What is a Personal Health Budget (PHB)? PHBs are the allocation of NHS funding which patients, after an assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people to exercise choice and control over their lives is central to achieving better outcomes for individuals. For Eligible 2Persons there is a duty on CCGs to: • Consider any request for a PHB; • Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs. There are five essential characteristics of a PHB. The person with the PHB (or their representative) must: 1. be able to choose the health outcomes they want to achieve 2. know how much money they have for their healthcare and support 3. be enabled to create their own care plan, with support if they want it 4. be able to choose how their budget is held and managed 5. be able to spend the money in ways and at times that make sense to them,
as agreed in their plan.
2 An eligible person is someone in receipt of NHS Continuing Health Care Page 10 of 14
Phase One Engagement (To be completed by the end of February 2016 by Sefton Carers Centre in conjunction with South Sefton CCG & Southport & Formby CCG) Timescale for engagement: The engagement will cover a 4 week period from 1st February – 29th February 2016 Due to timescales involved, representation of the groups below will be sought from pre-existing groups that meet to support these health conditions. Method of engagement: Focus groups with a maximum of 10 people per group Patient representation groups to include:
• Parents of children eligible for Continuing Health Care (CHC). If a child receives CHC, they will have an education, health and care plan (an EHC) plan, or will be transferring to one very soon.
• Adults eligible for CHC, including individuals with Long term health conditions, Learning disabilities and Mental health conditions.
• Service users in receipt of PHB’s. The engagement process will include residents from both the North and South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process as indicated in Appendix A. Areas to receive feedback on: Individuals will be shown copies of literature that has been compiled to promote and explain what Personal Health Budgets are. The engagement will seek to address and clarify the understanding of the points below;
• Is there an understanding of what the offer of a PHB means? Specifically, seeking understanding on what the distinction between the ‘right to ask’ and ‘right to have’ change means in practice, gather expectations of this.
• Assess how well people feel their needs are understood and how well their needs are currently met
• Assess if any individual has been turned down for PHB in the past, what did they ask for and was it explained clearly and understood the reasons for PHB being turned down
• What would be the likeliest use for PHB funding should it be received • What is felt to be the biggest barrier to accessing the funding • General concerns/reservations from actual or potential PHB budget holders • Testing of literature for proposed leaflets including a standard leaflet and an
easy read version in addition to proposed website text to receive feedback on if the level of information is sufficient or there are any changes required to be made to address any areas not currently covered/explained sufficiently The above are the key themes/questions which will be used to shape the discussions.
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How the engagement may help to shape future work plans: • Look to revise proposed literature dependent on feedback from the
engagement process if changes are requested to be made • Managing expectation, working with service users, local residents, NHS
workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton.
Phase 2 engagement process post 1st April 2016 to focus on NHS professionals across the wider NHS, partner organisations and service users. Timescale for engagement: The engagement will cover a 4 week period from 1st April – 30th April 2016 Due to timescales involved, representation of the groups below will be sought from pre-existing groups that meet to support these health conditions. Method of engagement: Focus groups with a maximum of 10 people per group and 1:1 interviews with NHS professional to be flexible with work commitments NHS Professional representation: To engage with a range of NHS professionals across the wider NHS workforce Patient representation groups to include:
• Parents of children eligible for Continuing Health Care (CHC). If a child receives CHC, they will have an education, health and care plan (an EHC) plan, or will be transferring to one very soon.
• Adults eligible for CHC, including individuals with Long term health conditions, Learning disabilities and Mental health conditions.
• Service users in receipt of PHB’s. Partner organisation engagement: To engage with partner organisations across the voluntary, community and faith sector to ensure that the local offer of PHB’s is understood and organisations can promote PHB’s locally as an option to service users. The engagement process will include residents from both the North and South of the borough of Sefton. Protected characteristics data will also be collected as part of the engagement process as indicated in Appendix A. How the engagement may help to shape future work plans:
• Look to revise proposed literature dependent on feedback from the engagement process if changes are requested to be made
• Managing expectation, working with service users, local residents, NHS workforce and partner agencies is key in clarifying and being realistic as to the delivery of PHB’s in Sefton.
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Appendix A – Equality Monitoring Data About you And now a few questions about you. NHS South Sefton Clinical Commissioning Group/NHS Southport and Formby Clinical Commissioning Group wants to provide local people with high quality health services. We can only do this if we understand who our patients are and what our local population needs. You can help us by completing the following questions. The information you provide is confidential and will be used for monitoring purposes only.
Are you a disabled person? Yes No
If yes, please tell us what your disability is related to:
Learning Mobility Vision Mental health Deaf/ hearingimpairment A hidden impairment Other
Please tell us your postcode (the first three characters):
What is your age?
16 or under 17 - 25 26 - 35 36 - 45 46 - 55 56 – 65 66 - 75 Over 75 Prefer not to say
What is your ethnic group/background? White British White Irish East European Gypsy/Roma/Traveller White Other Mixed White/Black African Mixed White/Black Caribbean Mixed White/Asian
Mixed Other Asian/ Asian British – Indian
Asian or Asian British – Pakistani Asian/Asian British – Bangladeshi
Asian or Asian British – Other Black/Black British – Caribbean
Black/Black British – African Black/ Black British – Other
Chinese Any other ethnic group Prefer not to say
Do you have a religion or belief?
No religion/belief Christian (C of E, Catholic, Protestant and all denominations)
Hindu Jewish Muslim Sikh Other Prefer not to say
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Thank you for completing this survey. Your feedback is very much appreciated.
What is your sexual orientation?
Heterosexual / straight (attracted to the opposite sex) Gay/Lesbian (attracted to the same sex) Bisexual (attracted to both sexes) Prefer not to say
Is your current gender identity the same as on your birth certificate?
Yes No Not sure what
the question means?
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Personal Health Budgets
What do they mean?
In Sefton
Produced by Midlands and Lancashire Commissioning Support Unit for NHS South Sefton CCG & Southport & Formby CCG Copyright © 2015 Midlands and Lancashire Commissioning Support Unit. All rights reserved V0_1 October 2015
Introduction The aim of Personal Health Budgets (PHBs) is that patients are given a set amount of money and can decide what care is best for them, in partnership with their NHS team. PHBs are aimed at giving you more choice and control over how money is spent on meeting your health care and wellbeing needs. Together with your NHS team you will develop a care and support plan. The plan sets out your personal health and wellbeing needs, the health outcomes you want to achieve, the amount of money in the budget and how you are going to spend it. Who can have a PHB? From 1 October 2014, adults who are eligible for fully funded NHS Continuing Healthcare funding, and children eligible for NHS continuing care, have a right to have a PHB. Your Continuing Healthcare funding and care package will remain in place if you choose not to have a PHB. It is completely voluntary.
What is a PHB? A PHB is an amount of money, paid to you by the NHS to meet your healthcare and wellbeing needs; planned and agreed between the person or their representative and the local NHS team. You will be able to use your budget for a range of things to help you meet your goals, including personal care and equipment. What does this mean for me? People who are eligible for NHS Continuing Healthcare and Continuing Care for children will have much more say over how their health and wellbeing needs are met. If you are receiving direct payments through social services, you may be able to transfer to a PHB with minimal or no disruption to your current arrangements if you become eligible for NHS Continuing Healthcare. Who is delivering PHBs for patients in Merseyside? The NHS North West Commissioning Support Unit (NWCSU) Continuing Healthcare Team are delivering PHBs with South Sefton CCG and Southport & Formby CCG. It is the CCGs, which are local NHS groups, which buy healthcare services on people’s behalf who are delivering PHBs with organisations providing support. Currently these organisations include Salvere, Your Life Your Way and SOLO Support Services. It is envisaged that over time a wider range of organisations, and therefore choice, will become available. These arrangements will be reviewed on an ongoing basis. How does it work? There are three key steps to meeting health and wellbeing needs under the PHBs system: Step 1 – assessment of needs Your care coordinator will ask you questions to find out what you need for your health and wellbeing. Step 2 – budget allocation
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Your assessment of needs is used to calculate an ‘indicative budget’. An ‘indicative budget’ is an estimate of the money needed to meet your health and wellbeing needs. Step 3 – support planning and using the budget Your care coordinator will then work with you, and those who support you, to decide how best to use the PHB to meet your needs. This will include your choice of how care is delivered. This is written in a support plan, which both you and your care coordinator must sign. While it can take some time to set up your health budget, we will make sure that this doesn’t cause a delay in being discharged from hospital and an interim care package may be offered. Will it affect my benefits? A PHB is not a welfare benefit and is not a part of the benefits system. This means that a PHB is not taken into account when calculating your benefits entitlement. PHBs are given in order to meet health and wellbeing needs, and cannot be spent for any other reason. The Merseyside NHS CCGs have a duty to ensure that payments are being used for what has been agreed with your care coordinator and documented in your support plan. The NHS CCGs are entitled to recover any money that is not spent appropriately. Whatever form of PHB is used, the assessment and review process for Continuing Healthcare remains as it is now. From where does the money come? The funding comes from the same pot of money which pays for either fully funded NHS Continuing Healthcare or Continuing Care for children. How will PHBs work for me? The budgets could work in three ways: 1. Direct payments – This is where either you or one of the agreed support service suppliers
holds the funds to buy the care and support you and your local NHS team decide you need. For audit purposes you or your support service supplier will have to show on what the money has been spent. You will be the employer and will buy and manage the service yourself, supported by the support service supplier as your human resources advisor.
2. A notional budget – With a notional budget no money changes hands. You find out how
much money is available and then talk to your local NHS team about the different ways to spend that money on meeting your needs. They will then arrange the agreed care and support.
3. A budget held by a third party – This is where a non NHS organisation holds the money for
you and helps you decide what you need. After you have agreed this with your local NHS team, the organisation buys the care and support you have chosen, and they become the employer.
For people who lack capacity The agreed representative is responsible for managing the direct healthcare payment, and buying and managing the service. The representative is responsible for the money and, for audit purposes, has to show on what the money has been spent. The representative must involve the individual and act in their best interests.
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Must I have a PHB? People do not have to change the healthcare and support that is working well for them, but if there’s something that isn’t working, that can be changed. On what can my budget be spent?
The aim of PHBs is to allow you real flexibility in planning the care that you need. PHBs are intended to be used for a range of services to help meet people’s goals, such as personal care and, in some cases, selected equipment. People will not pay for emergency care or normal care from a family doctor from their PHB budget.
On what can’t I spend my PHB? People are not allowed to spend the money on: • gambling • debt repayment • alcohol • tobacco • anything unlawful The PHB can’t be used to part-fund treatments alongside patients’ own money. If a patient for any reason wanted to purchase additional care, privately, this would need to take place separately. However, a patient could use their budget to purchase private services that meet their personal health outcomes e.g. a private physiotherapist. Can I employ a relative? Ordinarily, no. The CCG / NWCSU will need to confirm that it is necessary to employ a relative / partner or anyone living in the same household as you, in order to satisfactorily meet your care needs for that service; or to promote the welfare of a child for whom direct healthcare payments are being made. If family members, close relatives and / or people living in the same household as you are to be employed, using a direct healthcare payment, the CCG / NWCSU must agree and record this in the care plan. Will I be asked to show how I have spent the money? Yes, patients are required to keep basic records. Your PHB bank account will be audited. PHBs can only be used as agreed in your PHB care plan. The records will be subject to audit arrangements by NWCSU Finance Department. The balance of the bank account will be reviewed regularly and any money that has not been allocated to your care or support, excluding the contingency funds, will be returned to your CCG (unless a prior agreement has been made with the care coordinator).
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More information Depending on personal preference, there are two organisations working with your local NHS who support people with PHBs. Salvere will help you to employ your own team of staff or SOLO will employ your team of staff. Contact them or see their websites for more information. Salvere: Visit www.salvere.co.uk
By Telephone: 01772 535683 By email: [email protected] By post: Salvere
Suite 6 Leyland House Lancashire Business Park Centurion Way Leyland PR26 6TY
SOLO Support Services Ltd: Visit www.solosupportservices.co.uk By Telephone 0115 815 7010 needs formatting By Textphone: 0115 815 7010 By email: [email protected] By post: SOLO Support Services Ltd
34 Millicent Road West Bridgford Nottingham NG2 7PZ
Your Life Your Way: Visit www.ylyw.org By Telephone 0845 387 1107needs formatting By email: [email protected] By post: YLYW
8 Brunel Court, Rudheath Way Gadbrook Park, Cheshire CW9 7LP
If you want to share experiences, advice and support with other people who have a PHB, their carers and families, you can visit the peoplehub website: www.peoplehub.org.uk. NHS Choices helps people find reliable information about treatments, conditions and healthy living, and to comment on their own hospital experience at www.nhs.uk Find out more about PHBs on NHS Choices at www.nhs.uk/personalhealthbudgets To find out all about choice go to: www.nhs.uk/choiceinthenhs/yourchoices/allaboutchoice/pages/allaboutchoice.aspx For more information about the right to choose where you get treatment, ask your GP, CCG or visit: www.nhs.uk/choiceintheNHS/Yourchoices/Pages/Yourchoices.aspx
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Your health, your way (also called the patients’ prospectus) supports people to take a more active role in decisions about their care, control their condition better, and have a better quality of life visit: www.nhs.uk/Planners/Yourhealth/Pages/Yourhealth.aspx Information Prescriptions are a quick and easy way to provide information about your condition and local services at: www.nhs.uk/ipg/Pages/IPStart.aspx NHS complaints information - If you unhappy with your NHS services Contact: North West CSU Customer Care Team TBC TBC TBC TBC Telephone: TBC Email: TBC
CCG Contact Details TBC
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Personal Health Budget (PHB) Engagement
Phase one – Focus group / telephone/face to face interviews
Areas to receive feedback on:
Individuals will be shown copies of literature that has been compiled to promote and explain what Personal Health Budgets are. The engagement will seek to address and clarify the understanding of the points below;
• Is there an understanding of what the offer of a PHB means? Specifically, seeking understanding on what the distinction between the ‘right to ask’ and ‘right to have’ and what this change means in practice, gathering individual’s expectations of this.
• How well do people feel their needs are understood and how well their needs are currently met
• Has any individual has been turned down for PHB in the past, what did they ask for and was it explained clearly and understood the reasons for PHB being turned down
• What would be the likeliest use for PHB funding should it be received
• What is felt to be the biggest barrier to accessing the funding
• General concerns/reservations from actual or potential PHB budget holders
• Testing of literature for proposed leaflets including a standard leaflet and an easy read version in addition to proposed website text to receive feedback on if the level of information is sufficient or there are any changes required to be made to address any areas not currently covered/explained sufficiently
The above are the key themes/questions which will be used to shape the discussions.
All about personal health budgets
Getting the healthcare you need
Easy Read
About this leaflet
The National Health Service (NHS)
has written this leaflet.
This leaflet talks about personal
health budgets and tells you:
• What a personal health budget is
• Why we think they could help
people
• how some people use their
personal health budget
• how to find out more
All about personal health budgets Getting the healthcare you need 1
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What is in this leaflet
About personal health
budgets
How personal health
budgets work
What you can use a
personal health budget for
Important things about
personal health budgets
How some people use their
personal health budget
Questions about personal
health budgets
How to find out more 19
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About personal health budgets
The NHS has a lot of ways to make
it easier for you to get the best
healthcare for you. A personal
health budget is one of these.
A personal health budget is money
to pay for your healthcare. At the
centre is your care plan, which helps
you decide your health goals
together with your local NHS team.
This means:
• you agree the best way to spend
the money with your local NHS
team. This could be your nurse,
doctor or care manager.
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• you know how much money
there is for your healthcare
• you have more say about your
healthcare
Some people already get a personal
budget to pay for support from
social services.
Now personal health budgets work
in a similar way.
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How personal health budgets work
You must spend the money on
things in your care plan that keep
you healthy and safe.
The local NHS has to agree that
these things support your health.
If things are working well at the
moment, you do not have to
change them.
But a personal health budget
means you can change things if
you want to.
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Personal health budgets can work
in 3 different ways, or a mixture
of them:
1. Notional budget
We tell you how much money there
is for your care
You say how you want us to spend
the money. If your local NHS team
agrees this meets your needs they
arrange the care and support for you.
2. Real budget held by a third party
An organisation, like a charity, looks
after the money for you and helps
you spend it. They are called the
third party.
If the local NHS agrees with how you
want to spend your money, the
organisation buys the care and
support for you.
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3. Direct payment for healthcare
We give you the money to buy and
manage your own healthcare and
support.
Your local NHS team must agree
that this meets your needs.
You have to tell us what you spend
the money on.
What you can use a personal
health budget for
As long as you agree your care plan
with your local NHS team, you can
use the budget for most types of
healthcare and support.
You can use the budget for things
like:
personal care
doing things that help
you keep well
8 All about personal health budgets Getting the healthcare you need
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equipment to help meet
your health needs.
You cannot use a personal health
budget to pay for:
emergency health
services
services you normally
get from your family
doctor
things that are not legal
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paying back money that
you owe other people
gambling
alcohol and tobacco.
Your NHS team will have rules about
what should be in your plan. They
should tell you these before you
write it.
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Important things about
personal health budgets
• this is still the NHS. So no one
will have to use their own
money to get the NHS care
they need
• services you get using your
personal health budget should
work well and be safe
• using the services should be a
good experience
• personal health budgets should
help all people get the best
services from the NHS. They
should not make things worse
for anyone
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• you do not have to use a
personal health budget if you
do not want to
• you should have as much
control over decisions as you
want
• organisations that provide your
healthcare and social care
should work with you and with
each other to give you the best
possible service
• if you are not able to have a
personal health budget, you can
still ask your local NHS team
about different ways they could
support your needs in a way that
suits you.
personal health budgets are
starting up slowly to help people
with disabilities or illness which
last for a long time.
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We tried out personal health
budgets with a small number of
people in some parts of England
We found out that people’s lives got
better and people went to hospital
less often.
Personal health budgets seemed to
help people more if they needed a
lot of help with their health.
Because of this the Government said
that everyone who gets a type of
support called NHS Continuing
Healthcare will be able to ask for a
personal health budget, including a
direct payment. NHS Continuing
Healthcare is for people who need a
lot of help because of their health,
and their health changes a lot.
After that, we hope anyone who
could get better care with a personal
health budget will be able to ask for
one.
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How some people use their
personal health budget
David
David uses a wheelchair and has a
personal assistant to help with
things he cannot do for himself.
His legs were very sore and a nurse
had to come and put new bandages
on them every day. David was often
late for work because he had to
wait for the nurse.
David used some of his personal
health budget to get his personal
assistants trained to change his
bandages any time he needs them to.
This means David has more
freedom and can go to work when
he needs to.
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Anita
Anita has a disease that means she
needs someone to care for her 24
hours a day.
She is fed through a tube 6 times a
day and her husband gave up work
to care for her.
Anita uses her personal health
budget to pay for a team of
personal assistants to look after her
at home.
This means she is always cared for
by people who know her and
understand her needs.
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Questions about personal health
budgets
Who can have a personal health
budget?
People who get a kind of health
service called ‘NHS Continuing
Healthcare’ can ask for a personal
health budget. NHS Continuing
Healthcare is just for people who
need a lot of help because of their
health. Their health changes a lot.
Local NHS groups will be able to
offer a personal health budget to
anyone they think it would help.
Who decides who can have a
budget, how big is it, and what
can you spend it on?
Your local NHS will work out how to
make these decisions in your area.
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You should always be told how
much money you will have before
you start planning the things you
could spend it on.
Can I have a personal health
budget as well as a personal
budget from social services?
Yes. You can ask them to put this
together into 1 budget so you can
plan for all your needs.
Will I have to manage my own
care?
You will not have to do everything
on your own.
You and your family or carers will
agree a care plan with the NHS.
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This will say how you will spend
your budget to keep you healthy
and safe.
What happens if something goes
wrong or my needs change?
If your health changes or your plan
is not right for you, you can look at
it with your local NHS team and
change things.
You will always get NHS care in an
emergency.
You can go back to having NHS
care like you did before if a personal
health budget does not work for you.
Will I have to pay towards my
healthcare if I can afford it?
No. There should be enough money
in your personal health budget to
pay for the care you need.
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How to find out more
Talk to the person who helps most
with your care and support.
This might be your care manager or
a nurse.
They can talk about personal health
budgets with you.
If you have more questions or
would like more information
please:
• talk to your local NHS team
• look at the following websites:
NHS Choices
This website helps people get
good information about illness
and treatment and you can talk
about your own experiences:
www.nhs.uk
www.nhs.uk/personalhealthbudgets
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NHS Continuing Healthcare
You can find out more about NHS
Continuing Healthcare here:
www.nhs.uk/chq/pages/2392.aspx
Information prescriptions
This is a quick and easy way to provide
information about different health
problems and local services:
www.nhs.uk/ipg/Pages/IPStart.aspx
Peoplehub
The peoplehub website is a good
place to talk with other people who
have a personal health budget and
their families:
www.peoplehub.org.uk
NHS complaints information
If you are unhappy with your NHS service contact:
Midlands & Lancashire CSU
Customer Care Team
Jubilee House, Lancashire Business Park, Leyland PR26 6TR
Telephone: 01772 214200
Email: [email protected]
CCG Contact Details
Blackburn with Darwen CCG
Telephone: 01254 282000
Email: [email protected]
Chorley and South Ribble CCG
Telephone: 01772 214 200
Email: [email protected]
East Lancashire CCG
Telephone: 01282 644700
Email: [email protected]
Fylde and Wyre CCG
Telephone: 01253 306305
Email: [email protected]
Greater Preston CCG
Telephone: 01772 214 200
Email: [email protected]
Lancashire North CCG
Telephone: 01524 519369
Email: [email protected]
West Lancashire CCG
Telephone: 01695 588000
Email: [email protected]
CHANGE
This easy read document was produced by CHANGE
All Images © CHANGE
www.changepeople.org
Pre consultation - Equality Analysis Report – New PHB Policy Date: Signature: Signed off (senior manager):
1. Scope of this Assessment:
This document is a ‘pre consultation assessment’ and its focus is:
• Early identification of issues liked to protected characteristics.
• Identify likely consultation routes , methods and needs linked to Protected characteristics
• Issues that obfuscate and detract from person centred processes
Post consultation, evidence will be viewed and analysed
2. Details of service / function: Introduction of Personal Health Budgets for people that are eligable for Continuing Health Care within NHS parameters.
History
Following a successful pilot programme by the Department of Health, which ended in October 2012, the Government announced that from April 2014, Eligible Persons will have the “right to ask” for a Personal Health Budget (PHB) , including by way of a direct payment. From October 2014, this right to ask was converted to a “right to have” a PHB.
This development mirrors other changes within the NHS, including the drive generally for greater patient choice, shared decision-making and innovation in managing funds. The Government has confirmed a commitment in the NHS mandate 2014-2015 that anyone with a long term condition, who can benefit from a PHB, should have the right to ask for one by April 2015.
What is a Personal Health Budget (PHB)?
PHBs are the allocation of NHS funding which patients, after an assessment and planning with their clinical team, are able to personally control and use for the services they choose to support their health needs. This enables them to manage identified risks and to live their lives in ways which best suit them. Enabling people
to exercise choice and control over their lives is central to achieving better outcomes for individuals.
For Eligible 1Persons there is a duty on CCGs to:
• Consider any request for a PHB; • Inform them of their right to ask for a PHB (April 2014); • Inform them of their right to have a PHB (October 2014) • Provide information, advice and support in relation to PHBs. There are five essential characteristics of a PHB.
The person with the PHB (or their representative) must:
1. be able to choose the health outcomes they want to achieve
2. know how much money they have for their healthcare and support
3. be enabled to create their own care plan, with support if they want it
4. be able to choose how their budget is held and managed
5. be able to spend the money in ways and at times that make sense to them, as
agreed in their plan.
3. Change to service and potential discriminatory barriers
The ‘right to ask’ moving to the ‘right to have’ PHBs is the central concept, however; the policy needs to be clear on what this distinction means and how it can be tested.
Potential barriers leading to direct and indirect discrimination:
1. Inappropriate assessment (assessors not understanding needs identified by the individual/cares linking to wellbeing’)
2. Variation is quality of assessments (subjectivity).
3. Uneven access to the provision across the community.
4. Access to the provision difficult due to linguistic/ written material.
5. Poor data collection around equality and outcomes
All of the above factors cut across protected characterises of ‘ age, disability, Gender reassignment, marital status, race, religion, sex and sexual orientation’.
1 An eligible person is someone in receipt of NHS Continuing Health Care
4. Does this service go the heart of enabling a protected characteristic
to access health and wellbeing services? YES: the additional funding from PHB is to enhance the quality of life.
5. Consultation: Who do you need to consult and engage with?
External Consultation – Expectation to be completed by 29th January 2016
• Patient representation (being identified via LD, MH, Childrens’ commissioners & service users in receipt of PHB’s)
• Local Authority • CSU contracts and CHC • 3rd Party organisations • Carers Centre • NHS Community Providers
In addition to the above include:
1. Disabled people/Disability groups (Sefton CVS) Ensure that:
2. Monitoring process to capture protected characteristics. a. Test service providers on types of needs connected to different
protected characteristics ( e.g. men/women, ages , different disabilities, religions/Culture, BME
b. Service users: collect protected characteristics data as part of questionnaire/consultation.
3. Question user groups on: a. ‘how well do they think their needs are understood’ b. ‘how well do they think their needs are met’ c. ‘Have they been turned down for (PHB) funding in the past’ what did
they ask for? d. ‘What would be the likeliest use of funding should they receive it?’ e. ‘What do they think the biggest barrier to accessing the funding would
be?
6. Is there evidence that the Public Sector Equality Duties will be met
(a) Eliminate discrimination. – The guidance needs to establish processes to ensure that:
i. Eligible Patients requests will be given unbiased consideration.
ii.Variations across assessments can be identified and homogenised to ensure consistent and considered judgments
iii. Sub-optimal outcomes are interrogated as to why they are sub-optimal to eliminate subjectivity and unconscious bias of assessors.
(b) Advance equality of opportunity
In principle PHB offers opportunity’s to enhance life’s chances and quality of life, Results of consultation need to be evaluated before final assessment on whether PSED are met.
C Foster good relations between different protected characteristics- Not engaged.
7. Potential risks that need to be mitigated: Immediate action plan: Risk 1 • Revise policy to ensure it is clearly understood what the
difference and meaning is between ‘right to ask’ and ‘right to have’.
• Include definition of ‘eligible person’ • Highlight and make clear that PHB is not to cover
services and facilities as a result of the lowering of Social Care payments by LA
Risk 2 Identify processes within the policy to ensure assessments are non-discriminatory
Risk 3 Identify user groups to include in consultation plans
Risk 4 Ensure that service providers identify issue linked to different protected characteristics.
Risk 5 • Ensure consultation process is accessible and uses different formats.
• Ensure consultation incorporates minority groups • Ensure that consultation can record inputs by protected
characteristics ( to enable disaggregated analysis) Risk 6 Ensure consultation with service users included questions (or
questions of that type) highlighted above at section 4.3.