The Department of Health has indicated its determination to roll out personal health budgets despite NHS managers warning they result in increased bureaucracy and run counter to the need to control costs.
The initiative, which has already been introduced for social care, is being trialled at 61 sites, 20 of which are described as “in depth” pilots. Invitation to join the trial was launched in 2009. About 1,500 patients, most with long term conditions, have so far been recruited and the government hopes to sign up another 500.
Speaking in London last week, at a Westminster Health Forum event, Birmingham Health and Wellbeing Partnership personal health budgets project manager Azra Iqbal said that, while popular with patients, it was difficult finding an efficient way of dealing with the “systems and processes” involved in administering the budgets.
Ms Iqbal said: “There is a lot of bureaucracy. Simple things like if the patient requests a supplier that is not on our system – it can take up to six to eight weeks just to get someone on our procurement register. That isn’t personalisation, that’s just another waiting list.”
NHS Nottingham City personal health budgets project manager Gemma Newbery said the budget process was time consuming and running the pilots was very difficult “in times of financial challenge”.
She said that despite “being told that budgets are being cut all over the place” the PCT was being asked to spend money on personal budgets without seeing any savings from the initiative.
Former national director for social care transformation Jeff Jerome, who led the introduction of individual budgets in local authorities, also acknowledged “process creep” had been a “major problem”, creating “an incredibly bureaucratic process”.
Andrew Sanderson, deputy director of the DH policy support unit, admitted the need to cut spending on administration had “made a difficult job even more difficult for many pilot sites”.
But he said there was a “depth of commitment across government towards developing personalisation services”.
He said: “I think I can be really confident that nothing is going to happen to reduce the drive to develop and roll out personal health budgets.”
A three year evaluation of the pilots, led by Kent University, is due to report next year.
Interim reports last July and November set out early findings from setting up the pilots. The reports suggested patients liked the budgets but added the programme consumed significant amounts of staff time.