Personal health budgets – what do you know?
Sometimes we come across concepts, ideas or abbreviated terms in medicine that completely confuse us. It may be that we simply do not possess enough information about the subject. With our scientific background and hopefully our inquisitive nature, we should not be afraid to ask questions about the area in doubt, to help us understand it.
When I came across a recent Univadis article about the BMA's unease over personal health budgets, I had to admit my lack of knowledge about this whole subject. Fortunately I am not alone, as according to the article, "a recent BMA survey revealed that 72% of doctors feel they are not very well informed or not informed at all about personal health budgets" (click here).
Apparently the government is keen to move forwards with this project. For those wanting to know more you can follow the link to the BMA resource on it at the end of the article (click here). The definition of personal health budgets given is: "Patients with certain long term conditions are allocated a pot of money to spend on their individual needs." You will be pleased to hear that the budget "cannot be used to pay for alcohol, tobacco, gambling or debt repayment, or anything that is illegal".
Reading the BMA information, it appears there is a problem with this policy that is far from unique in the NHS. There is a worrying lack of evidence on outcome data and it does concern me how this project will work in practice. The BMA article mentions that "the patient works with their local NHS team to agree a care plan, setting out how the budget will be spent". This begs the question: which NHS team? My fear is that GPs will be sucked into the process somewhere along the line. We could be involved in the administration of this project, something I doubt many will relish. Interestingly, the RCGP is keen that GPs are involved.
Of course, it is important to hear all sides of the story, particularly to hear more from people who support the project. However, the apparent lack of evidence, the GP management time it could consume and the potential for GPs to be responsible for managing the flow of money, does fill me with a degree of anxiety, unless someone can reassure me. If GPs are significantly involved, it could stretch us even further. But at least I now know more about this subject and can watch it evolve and await future developments, with great interest.
Dr Harry Brown, editor-in-chief Univadis
By Dr Harry Brown