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Case study: Personal Health Budgets impact case study

This evaluation study informed wider roll-out of personal health budgets in the NHS in 2014.

 

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Evaluation of the Personal Health Budgets Pilot

Key features

  • April 2010 - June 2011
  • Multi-site, controlled study
  • 2,235 patients recruited, with support from the NIHR Clinical Research Network
  • Funded by Department of Health
  • Chief Investigator: Professor Julien Forder, Head of School of Social Policy, Sociology and Social Research, University of Kent

Personal health budgets are designed to increase patient choice and control over how their health and care services are delivered. A budget is agreed between the patient and the local clinical commissioning group to support the patient’s healthcare and wellbeing needs.

The programme was launched as a pilot by the Department of Health in 2009, and a national evaluation was commissioned to run alongside it. This evaluation aimed to see whether access to these budgets led to patient benefit, and whether it was cost effective compared to the usual way of delivering services.

The evaluation used a controlled study to compare the outcomes and costs of patients selected to receive a personal health budget with those continuing with conventional support arrangements (the control group). Just over 1,000 individuals recruited to the personal health budget group and an additional 1,000 recruited to the control group were followed by the research team for 12 months.

The NIHR Clinical Research Network (CRN) supported local pilot sites with recruitment, exceeding the target numbers required. In some pilot sites, the NIHR CRN also supported the data collection that was required as part of the study, involving a baseline questionnaire and interview with patients.

Outcomes and findings

Net benefits were measured in terms of care-related quality of life on the Adult Social Care Outcome Toolkit (ASCOT) measure.

After a year, the use of personal health budgets led to a significant improvement in patients’ care-related quality of life and psychological well-being.

The personal health budget group showed greater benefit (quality of life) at less cost, on average, than the control group.

Whilst these budgets did not impact on outcomes such as health status, mortality or health-related quality of life, overall they were considered cost-effective.

Budget holders experienced greater benefits than people receiving conventional services, and the budgets were worth the cost.

Value to the NHS

People who used personal budgets had better care-related quality of life, and in monetary terms, this improvement was worth between £1520 and £2690 per patient.

Overall, the results suggested that personal health budgets could cost-effectively improve care-related quality of life results, without negative effects on health status.

The evaluation informed wider roll-out of personal health budgets in the NHS in 2014.

Dr Karen Jones, Senior Research Fellow, University of Kent:

“The NIHR Clinical Research Network provided valuable support during the Department of Health-funded national evaluation of the personal health budget pilot programme. The findings from the evaluation have informed the current personalisation agenda and the national rollout of personal health budgets following the pilot phase."