Survey

The report is based on a survey of over 600 social care workers, psychiatrists, psychologists and community psychiatric nurses, not currently involved in the personal budget pilot programme, and backed up by 60 in-depth interviews. It says clinicians especially are not yet convinced that personal health budgets will benefit patients. 

Fifty one per cent of healthcare professionals agree that personal budgets will enable a positive shift in power and control to service users, whereas only 20 per cent disagree. Overall, however, just 28 per cent of respondents said they have any enthusiasm for personal health budgets to be implemented.  

Read the report

Download the joint Mental Health Network and National Mental Health Development Unit report from our publications library.

Concerns

Concerns in the report centre around: 

• an absence of evidence that patient choice delivered through personal health budgets will improve health outcomes. This is a particular concern for doctors – 71 per cent of psychiatrists, 62 per cent of psychologists and 53 per cent of GPs cited lack of an evidence base as the major barrier to implementation.
• by reducing face-to-face time with patients, the bureaucracy involved in planning and administering personal health budgets could outweigh any potential benefits. This is a particular concern for frontline professionals who already have experience of personal budgets in social care. 74 per cent of community psychiatric nurses, 58 per cent of social workers and 48 per cent of occupational therapists rated this as the most important barrier. 

The Government is currently piloting personal health budgets and has given strong support for a roll-out of personal health budgets starting in 2012. The report recommends that professionals be involved more actively through a wide-scale programme of workshops and learning events across the country.   

Momentum

Given this momentum, the report nevertheless makes it clear how vital it is to address the concerns of clinicians and scale up the level of engagement with NHS staff. It is clear that without the support of these professionals, personal health budgets runs a serious risk of not succeeding. 

'Buy in' vital

Even more than in social care, ‘buy in’ from healthcare professionals is vital because their training and clinical expertise means they can only recommend treatment and support that is backed up by evidence.  

Encouragingly, professionals' views are not yet fixed and the research identifies opportunities to overcome their concerns if the Government acts now. 

The NHS Confederation believes that the current academic evaluation of personal health budgets should continue long enough to provide robust evidence of their real impact on patient outcomes and experience – before a national roll out is considered. 

Mental Health Network comment

The NHS Confederation's Mental Health Network director Steve Shrubb said: “Our findings show there is widespread support for the concept of personal budgets among mental healthcare professionals. They recognise that empowering people to take control of the money spent on their care can be vital to recovery.  

“What we can not get around is that, while supportive of the idea of personal budgets, clinical staff are extremely worried that choice through personal budgets may not be backed up by sufficient evidence. 

“The history of reform in the NHS is littered with good ideas that have failed as the evidence base had to catch up with implementation or staff were not engaged.

“We believe personal health budgets have real potential for patients. They are an idea that deserves to be given a fair wind. In order for that to happen we need a proper evidence base that persuades the people who are responsible for people’s care. Although this will take a little more time, it is essential to make personal health budgets a reality. 

“It would be a great shame if such a good idea was implemented poorly so not everyone could benefit from it from day one. Developing the evidence base will be crucial so that, with a little patience, an idea whose time has come can truly deliver the benefits people overwhelmingly believe it is capable of.”