Lansley’s continuing care plan ‘could save £300m a year’

Health secretary Andrew Lansley’s plans to extend personal health budgets (PHBs) to people receiving continuing healthcare could save £300m a year nationally, findings from the pilots suggest.

A study in Norfolk found that extending PHBs to half of continuing care clients could save £605,000 a year, based on giving people on continuing care budgets worth 5% less than the care packages they would have otherwise received.

However, some PHB pilot sites are reporting savings of 20% to 30% on continuing care clients, meaning there was scope for £300m savings on the annual £2bn continuing care budget for England, said Jeremy Cooper, director of public services consultancy iMPOWER, which carried out the Norfolk research.

In his Conservative party conference speech, Lansley pledged to give all continuing care clients the right to request a PHB by 2014, though it would be at the discretion of health commissioners to grant the requests.

In Norfolk’s PHB pilot, continuing care clients were offered a budget worth 5% less than would have been spent on them, along with supported choice and control over how it was spent. The iMPOWER research found that they were satisfied with the level of the budget in terms of delivering outcomes.

If PHBs with a 5% funding reduction were extended to half of clients in the county, £605,000 would be saved in 2012-13, allowing for additional costs of support planning, brokerage and other services required by people with their own budget.

An independent evaluation of the pilots will be published in October 2012 but the government is already committed to rolling out PHBs.

Cooper said the business case for extending PHBs to people on continuing care was clear, though experience from the pilots showed achieving cultural change in the NHS would be key to making personal health budgets work.

This point was echoed by service user-led body the National Centre for Independent Living.

“We do not underestimate this cultural shift within the NHS where some commissioners may well refuse requests for personal health budgets due to lack of understanding,” said NCIL policy and external relations manager Bernd Sass.

He said NHS commissioners could learn from user-led organisations that provide support to people managing personal budgets, but warned these organisations were at risk from reduced funding.

However, the NHS Confederation’s Mental Health Network raised concerns about a PHB roll-out, saying the national evaluation needed to establish convincingly whether health budgets improved outcomes or user experience or reduced costs.

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