Action Plan
NHS England’s ambition is that by 2020 PHB’s will be part of the mainstream offer for patients in the NHS, representing 1-2 people per 1,000 population.
For North Yorkshire based on 2011 CCG population estimates this would represent an estimate of 763 people (1 person per 1,000 population) and 158 for Harrogate and Rural District.
How will we achieve this?
Approach:
The programme will be managed by focusing on outcomes or “I statements” which will be embedded into project planning. This will inform how CCGs commission in a more personalised way in the future, beyond the PHB project.
The “I statements” were developed in 2012, through the NHS Commissioning Board by National Voices, in order to develop a compelling narrative of care based on the experiences of patients, service users, carers and their organisations. These personal “I statements”, developed with the help of Think Local Act Personal (TLAP) and through national workshops and consultations, detail how care and support looks from the perspective of the person using the services. These cover:
o Care planning
o Goals and outcomes
o Communication
o Decision making
o Information
o Transitions
The personal health budget programme will include the following change projects:
1. Continuing Healthcare
2. Extended Local offer
3. Agreeing a roll-out plan for 2017-2020
A full action plan will be developed which demonstrates how each of the projects is achieving one or more of the “I statements”. Overview will be provided by the local Personalisation Programme Board which will include representatives with a lived experience of living with disability.
Reports will be made on progress via the “Markers of Progress” to NHS England and through the Health and Wellbeing Board metrics for NYCC.
Figure 1Personalisation Programme
Project Overview:
The three projects will be developed in more detail with stakeholders through individual task and finish groups.
1. Continuing Healthcare:
In 2016-2017 the CCG will continue to offer anyone receiving NHS Continuing Healthcare funding a PHB. Currently 174 people have a CHC funded package in the HaRD area and therefore have a “right to have” a PHB.
Based on the findings from NHS England’s Personal Health Budget pilot sites, around 30% of people receiving a Continuing Healthcare funded package are likely to take this up by 2020. In 2016-2017 uptake of PHB’s would be expected to continue to rapidly increase from the current baseline of 3 patients (3%) towards 30% of fully CHC funded patients. (34 people) This will include the following client groups; in addition many also receive joint funding from social care:
Harrogate and Rural Districts / Fully Funded CHC / Joint Funded / TotalChildren / 13 / 13
LD / 18 / 51 / 69
MH Adult / 7 / 4 / 11
MH Older Persons / 29 / 1 / 30
Physical Disability / 35 / 16 / 51
TOTAL / 102 / 72 / 174
Actions:
a) We will work with local authority partners to develop personalised support planning for people with joint funded care
b) We will work with local providers to develop a network of organisations who can act as third parties in supporting someone to hold their own budget
c) We will develop information and support online for patients and their families to find the support they need
d) We will work with NHS staff across organisations to offer support in a more personalised way
e) We will test new ways of working with the client groups outlined below
2. Extended local offer
As outlined in our local offer we will also extend the provision of Personal Health Budgets to focus on the client groups outlined below. For each client group we will identify a small cohort of people through engagement and coproduction with local partners:
· People with a learning disability/mental health condition who have had a psychiatric hospital admission and who are eligible for Section 117 Aftercare. (22 people in NHS Harrogate and Rural District Area)
· Children and young people with long-term healthcare conditions in receipt of a Health, Education and Care Plan
· the CCGs will work towards including those accessing Wheelchair services through consultation in 2016/17
We will do this by
· Including patients and their families or representatives in the way the project is run
· Testing new ways of working with small numbers of patients and their families.
· Working with TEWV and other local NHS providers to develop staff capacity to deliver more personalised services
· Learning from how other parts of the country are developing this agenda
3. Agreeing a roll-out plan for 2017-2020
During 2016 we will have a “big conversation” with local stakeholders about how the future should look for the population locally. This will inform how we develop local services, not just to deliver personal health budgets, but to deliver more choice and control for NHS patients in the future. We will consider in this process:
· How we harness the energy and support local communities and families offer
· ICT solutions including an e-market place
· Encouraging people to work as P.As in the community
· Partnerships we need to foster e.g. joint working with supported housing organisations, domiciliary care providers, extra-care housing, local authority care management teams, as well as local education authorities and schools
· Role of GPs and NHS staff in supporting personalisation of healthcare