Individual Emporwerment in Kent

Individual Empowerment in Kent

Georgina WaltonPersonal Health Budgets

Project ManagerKent County Council and NHS Eastern and Coastal

Kent


1. Kent: Overview2. Transforming Health and Social Care3. Personalisation within Kent Adult Social

Services4. Kent Card 5. Personal Health Budgets


Individual Empowerment in KentOverview of Kent • Population: 1.4 Million People• Variations of Deprivation• Challenge of Ageing Population: By 2026 it is expected:People aged 85+ to increase by 100%People 75+ to increase by over 60% People 65+ to increase by over 30%In Kent it is expected:

– 85+ 2,900 new dementia cases– 65+ 8,310 new dementia cases

Individual Empowerment in KentHealth and Social Care in Kent

2 Primary Care Commissioning Trust

3 Acute NHS Hospital Trusts

1 joint NHS & Social Care Mental Health Trust

1 Ambulance Trust, 1 Fire Service, 1 Police Service 1 Adult Social Care Services

On a typical day…..20,000 people see their Doctor

50,000 prescription items are dispensed

32,000 people are supported to live independently

60,000+ people work in the health & social care sector





Transforming Health and Social Care• Initially born out of the disability rights movement

in the late 1970s• The first legislation allowing Direct Payments for

social care was passed in 1996, in the Community Care (Direct Payments) Act.

• Our Health, Our Care, Our Say: A new direction for community services (published 2006)


1. Overview of Kent

2. Transforming Health and Social Care

3. Personalisation within Kent Adult Social Services

4. Kent Card

5. Personal Health Budgets


Individual Empowerment in KentAchieving this by:

• Information, advice and guidance

• Carers assessments and support

• Assistive technologyTelecare and Telehealth

• Enablement Services 6 weeks intensive free support• Consultation with Communities • Personal Budgets


Residential CareSheltered Housing

Living Independently

Domiciliary CareEnablement

Personal Assistant

Day careAdult EducationLeisure Centre

Day Opportunities

Service

Employment

Person agrees with Social Services how their needs will be met


Personalisation within Adult Social ServicesPersonal Budgets

An allocation of funding that can be used to purchase support from the public, private or

voluntary sector, managed by:• Social Services

• Private or voluntary provider• Individual as a Direct Payment

Must be used on meeting assessed social care needs

Individual Empowerment in KentDirect Payments

Used by people to make their own arrangements

Duty to offer this to virtually all people, including families of people who lack

mental capacity

Can be paid to:

• Bank account

• Kent Card




Individual Empowerment in KentBrief History• A new streamlined and cost effective solution

was required for delivering direct payments• A system was needed for people who have been

excluded in the past from having a direct payment

• Kent County Council in partnership with The Royal Bank of Scotland developed a system that would revolutionise the direct payment process


The result was the first pre-loaded card programme for Direct Payment recipients

‘The Kent Card’

Launched March 2007

Individual Empowerment in Kent Why did KCC introduce Kent Card?• To support the personalisation agenda in social

care and empower individuals• Reduce the complexity around direct payments:

- Kent Card removes the need to negotiate the opening of a bank account

- Each card is pre loaded with an agreed amount

Flexibility, Freedom, Choice and Control


RBS

Within 9 Working

Days

Funds Loaded - Day 3/4

Application Form

Cardholder detail spreadsheet

Crediting

Monthly Statements & Daily

Web-access

How the card works…..CARD ISSUING & LOADING

Individual Empowerment in KentKent Card Features• The ability to block spending in certain Merchant

groups• Cash facility is automatically restricted• Monthly statements • Detailed management and audit information

reporting• KCC 24hr helpline• Personal Assistants can be paid via Kent Card• Cardholder can nominate an additional

cardholder

Individual Empowerment in Kent Benefits for Providers who accept Kent Card• Payment credited to providers accounts directly,

this reduces processing time and associated costs

• Users of direct payments is set to increase• Providers are added to a list of UK suppliers that

accept VISA• Providers are added to the Kent County Council

website showing that they accept Kent Card• Increased business opportunities with the facility

of accepting VISA


Award winning Kent Card

Winner at the VISA European Awards ‘Best corporate social responsibility programme’

Kent Card was shortlisted for Innovation and Progress at Guardian Public Service Awards 2009 and The pre-paid awards 2009 category- Best Corporate or Government loaded programme



1. Kent: Overview

2. Transforming Health and Social Care

3. Personalisation within Kent Adult Social Services

4. Kent Card

5. Personal Health Budgets


Backdrop

“ You have the right to make choices about your NHS care and to information to support these choices. The options available to you will develop over time and depend on your individual needs.”

(Section 2a of the NHS Constitution)

Individual Empowerment in KentWhat’s involved?

There are 4 key stages Personal Health Budgets

Knowing amount of money in

the budget

Agreeing the Care plan which sets out:

• health needs / outcomes,• money in budget• What goods and services

will be bought and the cost of these

Managing the plan and getting

the care e.g. by direct payment

Monitoring and

Review

Individual Empowerment in KentDifferent ways of delivering a

personal health budget

Personal care plans

Notional individual

budget

Real budget held on the individual’s

behalf

Direct payment –

cash held by patient

Already legally

possible

Mo

re d

irect co

ntro

l to

ind

ivid

ua

ls


What can a budget be spent on? • Not emergency care or core GP services• Agreed care plan with agreed health and

wellbeing objectives• Services should be appropriate for the state to

provide – not gambling, debt repayment, alcohol, tobacco

Individual Empowerment in KentSix principles• Upholding NHS values • Quality is key!• Tackling inequalities and protecting

equality• Personal health budgets are voluntary• Decision making close to the individual• Partnership

Individual Empowerment in KentLocal key deliverables

NHS Eastern and Coastal Kent to pilot:• Continuing Health Care with 20 patients• End of Life Care with 4 patients• Maternity with 30 women• Carers• Mental Health with 20 individuals• Testing the potential of Kent Card

Individual Empowerment in KentLocal key deliverables

To build on the integrated commissioning structures between Health and Social Care, KCC has been supporting NHS Eastern and Coastal Kent and will test the potential of the Kent Card as the payment mechanism for the

Personal Health Budget


Why are Personal Health Budgets Important?

• Increasing satisfaction with services• Increasing health outcomes• Integration of health and social care• System efficiency and costs


Evaluation of the pilotThe independent evaluation team in place will report at intervals over 3 years, to include:

Health, wellbeing, experience and access

Variation by condition

and background

Financial impact

Effect on NHS

services

Practical – what works,

what doesn’t?

Impact on staff


March 2010Regulation in

place

Programme timeline

Summer 2010First interim

report published

2012End of pilots

and evaluation

April 2010Recruitment to

evaluation cohort starts

Mid-2010Direct payments allowed in pilots

(subject to regulation)


Key Challenges• Delivering Personal Health Budgets in a

time of financial challenge• Embedding Personal Health Budgets at

the heart of the NHS• Supporting cultural change

Individual Empowerment in KentThe Future of Personal Health Budgets• Big Society • One of a number of different forms of

personalisation being explored across the welfare state

• Future link all publicly funded support• Integration and joint processes• Giving people choice an control should be a way

of driving up quality

Some potential examples of things that can be included

• Equipment - electric wheelchairs, beds etc• Hydrotherapy • Complimentary therapy e.g. acupuncture• Air conditioning• Activities and classes instead of traditional

mental health services• Alternative respite arrangements



Case Study:

How Personal Health Budgets work in Kent

Individual Empowerment in KentKeys Lessons So Far• It takes Time • Cultural Shift • Support Systems are Essential• Development of Provider Market • Partnership Working

Individual Empowerment in KentRealising potential of Personalisation means:

• Better use of existing resources, • Improved communication and partnership working between professionals, users and carers, and across agencies, and• More flexible services focused on

the needs and priorities of service

users and carers.


Health & Medicine

Individual Emporwerment in Kent