Proceed ‘but with care’ on personal budgets, think tank argues

Over a million people will spend public funds on their own behalf through a personal budget, says a new report, Proceed with caution: What makes personal budgets work?’, from public services ‘think tank’, Reform.

In services like the NHS, the personal budget could reach £20,000 per year per person. Reform supports the wider use of personal budgets, but warns that ‘only the most rigorous evaluation’ will ensure value for money and high standards of service. It said: “Personal budgets give patients and other public service users freedom over how to spend an allocation of public money. Widely used in the NHS and social care, their use is increasing. 

Pilot schemes have given personal budgets to unemployed young people, mental health patients. and ex-offenders. For example, to improve rehabilitation, the Ministry of Justice gave money to people released from prison, which was then spent on college fees, computer courses, or trade vehicle car insurance.”

The Reform research finds that personal budgets have been ‘a good tool for tailoring public services to the needs of individual users’.

The authors, however, call for the Government ‘to tread carefully’, and to make sure the impact and value for money of personal budget schemes is properly assessed. Reform said: “Evaluations of personal budgets so far have measured impact on quality and life and autonomy, but not value for money. For example, a review of personal budgets in mental health found that only 13 per cent of trials looked at cost-effectiveness.”

Reform says that pilots have ‘tended to be small-scale and limited to specific local areas’, and have been bolstered by additional training and financial incentives, usually withdrawn once the pilot is complete, ‘potentially skewing the results’.

It added: “The best example of evaluation came from NHS England’s health pilot scheme, which ran between2009-2012 across a large area, and focused on both cost-effectiveness and quality of care. We call for the Government to apply the NHS’s rigorous method of evaluation to all other areas where personal budgets are piloted.” 

The report also shows that:

  • Around 700,000 people have some form of personal budget, which Reform expects will increase to ‘almost a million’ by 2024, in health and social care alone. It says support for the further roll-out of personal budgets is clear, with the Department of Health and Social Care recently consulting on offering the schemes to new groups, such as those leaving the Armed Forces.

  • No single figure for the total amount spent via personal budgets is available, but an average Personal Health Budget can total £20,000 a year, and 15.4 million people in England – over a quarter of the population – have a long-term condition which could make them eligible for one in the future.

The report’s authors are Claudia Martinez, Research manager, and Josh Pritchard, researcher.





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