9 Weeks to Health – UK…Personal Budgets

Patient centred care means what it says; listening to and organising care with and around the unique individual in front of you.  So what do patients say most often?  They tell you that their biggest desire is for the various providers and agencies they interact with to offer seamless services based on their previously disclosed needs.  In the UK they have taken this so seriously that they have legislated for integrated social and health care.

The UK experiment begins with personally controlled, combined budgets for people with long-term conditions.  Workshops and pilots are occurring across the windy isle to establish how this will unfold. It means Councils, historically the delivery agents of social care, and the NHS need to design systems and models which will allow patients real choice and control.  Notably, this system applies to more than the disabled as per Australia’s NDIS moves.  Hence, expect more patient influence and variety in how the system evolves.

It is expected that four paths will commonly be chosen.  The first is continuing to trust the “experts” to assign dollars.  The second is to take total control of the funds and allocate them to providers of choice, some of which may not fit the traditional model of social care at all.  The third is to allow a non-council or NHS broker to run with the challenge.  The fourth is a mix and match which suits the patient.

When such an approach is paired with the growing use of community care coordinators, Link Workers and other navigators of the care system, the impact will be profound.  The results of various pilot initiatives would indicate doctors are less stressed and patients are more engaged.  The outcomes generally result in management in the community at lower cost.  There will be a need for council and NHS providers to evolve to address patient preferences and more competition which may increase the complexity of choice.  However, these may be minor costs given the potential gains.

It sort of adds up to the old saying “if you take the ‘I’ out of illness and replace it with ‘we’ you end up with wellness.  A pretty good outcome it would seem.

Tracey Johnson, General Manager, Inala Primary Care

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