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.
Personal health budgets are being piloted in 64 areas from 2009-12, and the evaluation, by academics from Kent and York Universities, Imperial College and the London School of Economics, was based on interviews with project leads in 20 of the sites from April to June this year.
The report found PCTs had to find additional resources to fund personal health budgets as they could not extract money from block contracts with health providers.
Setting the value of the budget also caused problems, with PCTs taking a number of different approaches including approximating from the costs of existing care packages, trying to set costs based on the outcomes the patient was aiming to achieve and, where necessary, using “guesswork”.
The report also identified concerns in some sites about the level of choice and control delegated to patients, particularly where they were using direct payments as opposed to a “notional” budget that would be managed by the PCT. Some interviewees voiced concerns that patients might purchase low-quality services with a direct payment, but many said that risks could be managed by having adequate processes in place.
The evaluation team emphasised that these were early findings and the challenges faced by sites could change over time. Over the next two years, it will be interviewing patients, carers and other professionals to gauge the impact of the pilots.