Personal health budgets: a mechanism to encourage service integration?

Abstract

Purpose: Integrated care continues to be a central aim within health and social care policy in England. Personal budgets and personal health budgets aim to place service users at the centre of decision-making and are part of a wider long-term initiative working towards personalised and integrated care. Personal budgets began in social care with the national pilot programme of individual budgets, which aimed to incorporate several funding streams into one budget, but in practice local authorities limited these to social care expenditure. Personal budgets then moved into the health care sector with the introduction of a three-year personal health budgets pilot programme that started in 2009. The purpose of the paper is to explore the post-pilot implementation of personal health budgets and explore their role in facilitating service integration. We examine this through the RE-AIM framework. Design/methodology/approach: During 2015 and 2016, eight organisational representatives, 23 personal health budget holders and three service providers were interviewed, 42 personal health budget support plans were collected and 14 service providers completed an online survey. Findings: Overall, personal health budgets continued to be viewed positively but progress in implementation was slower than expected. Effective leadership, clear communication and longer-term implementation were seen as vital ingredients in ensuring personal health budgets are fully embedded and contribute to wider service integration. Originality/value: The paper highlights the importance of policy implementation over the longer-term, while illustrating how the venture of personal health budgets in England could be a mechanism for implementing service integration. The findings can serve to guide future policy initiatives on person-centred care and service integration.