What does POET tell us about people with personal health budgets?

January 15, 2018

In Control, Lancaster University and Think Local Act Personal have today, Tuesday 28th October 2014, published a national survey of the experiences of 129 personal health budget holders and 101 carers to look at the impact that personal health budgets are having on people's lives.


Twenty-two different NHS and council organisations in 13 areas took part in the survey, which aims to  identify the critical process conditions that clinical commissioning groups (CCGs), local authorities and partner agencies need to establish if they are to maximise the efficiency and effectiveness of personal health budgets.


The surveys showed positive outcomes for people with a personal health budget and their carers in feelings of independence, having choice and control and  improved quality of life and relationships with family. Carers also reported they felt positive in being able to continue caring. Very few people (between 0% and 5.4%) reported negative outcomes and responses, indicating personal health budgets worked well for people regardless of their age. Those people who reported worse health tended to report better outcomes.


The findings also showed the need to improve the experience of control of a personal health budget. The personal health budget process was reported as difficult by a substantial minority of people (11.9% to 22%). But this improved when people's views are taken into account in care planning and setting budgets and when they had support to plan.


Luke Oshea, Head of Integrated Personal Commissioning and Person Centred Care at NHS England, said: "I really welcome the latest POET survey. It's great to see such good results, with over 80% of people taking up personal health budgets reporting improved quality of life.  However there is still room to make personal health budgets easier. Over one in five people said that some aspects of the process were made too difficult. "The NHS Forward View published last week calls for an increase the direct control patients have over the care that is provided to them. As part of this, the new Integrated Personal Commissioning programme will provide an integrated budget that will be managed by people themselves, or on their behalf by councils, the NHS or a voluntary organisation. The good progress already being made on introducing personal health budgets provides an essential building block for the new approach."


The Government has committed the NHS to rolling out personal health budgets across England. People eligible for NHS continuing healthcare now have the right to have a personal health budget.


CCGs can also offer personal health budgets to others that they feel may benefit from the additional flexibility and control.


This commitment to personal budgets has been further strengthened recently by the announcement in July from NHS England for a new Integrated Personalised Commissioning (IPC) programme, which for the first time will blend comprehensive health and social care funding for individuals, and allow them to direct how it is used.


The introduction of personal health budgets to the NHS and the new IPC programme represents a potentially powerful innovation and power shift, as they allow individual patients the opportunity to direct resources previously managed by professional commissioners.


The intention is to improve individual choice and control and to ensure patients receive support and services that are tailored to their own individual needs and circumstances. This more personalised approach is ultimately intended to be more cost effective and lead to better outcomes.


Commenting on the findings, Julie Stansfield, In Control's chief executive said: "When used to their potential personal budgets are an important tool enabling people to get control over their lives. We have now moved on from questioning whether they have a role to play in public services, they are a clear part of the future of social services, education and health for people of all ages, but the question now is what can we do to make them work for people in the best possible way? This report gives us the clearest indication to date on what's working and what's not in their delivery and provides a very useful insight for councils and health organisations on where they need to focus their efforts.


"Critically this survey is based on people's direct reported experiences representing what it the reality for people. The positive difference that personal budgets are making to people's lives irrespective of their age or social care group is encouraging but it is very clear from the survey that these differences are only achieved when the control shifts from services to the individual.


Sam Bennett, Director of Think Local Act Personal, the national partnership transforming health and care through personalised, community-based support said:

"TLAP welcomes these findings and will continue to work with our partners and others to address the challenges of personal health budget delivery and the continuing experience of frustrating and unhelpful process. Strong leadership is needed to drive through the fundamental changes required to secure a sustainable system of personalised health care and support for the future. It is particularly important to learn the lessons from introducing personal budgets in social care to ensure partners in health and education provide the very best opportunity of making Personal Health Budgets and Education Healthcare Plans improve the lives of people with long term health conditions and young people with special educational needs."


TLAP Co-chairs and National Co-production Advisory Group members Marjory Broughton and Clenton Farquharson, said:

"The results from this survey are a powerful reminder of the reasons why we are undertaking the challenging task of mainstreaming delivery of personal budgets  -  that is to improve the experiences of people wishing to live their lives in the way that works best for them, their families and carers. There is much to learn about how we can make things better for everyone. We hope practitioners will read this report and act on its findings."


The report is based on the Personal Outcomes Evaluation Tool (POET) which has been developed by In Control and Lancaster University over the past 10 years as a way to measure what's working and what's not when it comes to personal budgets and personalised care and support. It was originally for use in adult social care but has now been developed for use in health, children's services and education. A version for providers is also in development.


POET Report October 2014                                                                                                                                            POET Summary Report














A separate report relating specifically to the data for personal budgets in social care is also available, you can find out more about this report here.


Third National Personal Budget Survey                                                                                                                    POET Adults Infographic













In the summer we published a report based on the development of POET for children's services and the experiences of children and young people with special educational needs and disabilities, see this page for more information.


Think Local Act Personal is a national partnership of over 50 organisations committed to transforming health and social through personalisation and community-based support. Find more information, including tools to help with improving the delivery of personal budgets and self-directed support here or get in touch at thinklocalactpersonal@scie.org.uk


Using POET

To find out more about POET and how your council can take part, visit our POET webpages or get in touch with us at poet@in-control.org.uk.