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Delivering personal health budgets for children and young people with complex health needs

Our Children’s Continuing Care Team in Leicester, Leicestershire and Rutland is the first to get all eligible children and young people requiring home care packages onto a personal health budget.

Background
Clinical commissioning groups (CCGs) in Leicester, Leicestershire and Rutland (LLR) wanted to improve the wellbeing of children with continuing care needs (complex health) by making personal health budgets (PHBs) the default offer for all those eligible children and young people (CYP) who require home care packages.

PHBs enable people with long-term conditions and disabilities (and their carers) to have greater choice, flexibility and control over the healthcare and support they receive. A Department of Health pilot found PHBs had a positive impact on care-related quality of life and wellbeing, and were cost-effective.

In April 2016 there was one PHB for children and young people in LLR. MLCSU’s LLR Children’s Continuing Care Team then began work to achieve the goal of moving all CYP historical and new cases eligible for homecare packages over to a PHB, through development of local processes and policy.

Action
Firstly, the team reviewed the process for obtaining funding for a complex care package. Barriers to introducing PHBs as a default offer were overcome with support from the CCGs to devise a new policy, in-depth discussions with the local authorities regarding updating their practices, and good working relationships with providers aided by regular update meetings.

A key step was taking the resource allocation system (RAS) tool from paper-based to online and combining it with the decision support tool (DST). The team used a live system called FACE (Functional Analysis of Care Environments) to determine the PHB.

Impact
PHBs are now the default offer for all eligible children in LLR who have home care packages. The biggest value lies in making PHBs more easily available to eligible children so they and their families have greater choice, flexibility and control over their care; which follows through during the transition period into adulthood.

The in-patient hospital experience is enhanced because locally it is agreed that the care package follows the child into the hospital setting. Accessibility to a PHB could assist in reducing admissions, by altering the provision at home to meet the needs of the child during times of illness.

As a result of being the first children’s CC team to have 100 per cent of eligible cases on a PHB (for those who have a home care package), NHSE asked them to share knowledge and best practice to other teams across the country.

So far, they have provided training at an NHSE study day and on a webinar. They have also directly helped teams in other CCG areas.

The level of interest shown in the group work sessions you facilitated demonstrates the value of your input and shared knowledge of delivery in this complex area.
Marie Reynolds, Senior Manager Personalised Care, NHS England

Thank you for the support plan, can I just say what a good job you have done on it, it’s clear and a true impression of A’s needs.
Family member for assistance given during the support planning stage

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