Service users doubtful over NHS personal budgets

Personal health budgets are at risk of failure in mental health after service users joined professionals in voicing doubts about the flagship policy to boost choice in NHS.

“Deeply engrained clinical, organisational and managerial cultures” needed to change to make mental health services less medicalised and more person-centred if personal health budgets were to work, found a report today by the NHS Confederation’s Mental Health Network, based on a survey of users.

The report follows a poll of professionals by the network, which found social workers and other mental health practitioners were unconvinced that personal health budgets would deliver improvements for service users.

Only a minority of service users surveyed said they would take up a budget, many saying they were confused about what a personal health budget was and were unclear about how it would integrate with similar social care budgets.

This comes with the government planning to roll out personal health budgets from October 2012 following pilots in 68 areas.

The Mental Health Network has urged the government to postpone the roll out, extend the pilot schemes and begin an extensive programme of professional engagement as soon as possible.

“There is clearly some scepticism among service users about personal budgets being just one more policy solution that promises so much and delivers so little,” said Steve Shrubb, director of the Mental Health Network.

“All of this in spite of the fact that personal budgets offer solutions to many of the frustrations people express about the care and support they receive.

“We think personal budgets can be a really powerful tool to improve services, but they will only work if both clinicians and service users – not simply policy makers – are convinced they will.”

Shrubb said service providers needed to show service users that they would be supported in using budgets and to convince clinicians that the system would work.

The survey revealed fear among service users that personal budgets would lead to valued existing services closing. Service users also emphasised that people should not have to go through repeated assessments as needs change and that more support must be given to those less able to express their needs to guard against widening health inequalities.

In a similar survey carried out in March, more than half of social workers (58%) and three-quarters of community psychiatric nurses (CPNs) said they feared the bureaucracy involved in administering the budgets would outweigh any potential benefits.

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