Personal budgets, direct payments and self-directed support for people with severe mental health problems

Researchers: Gillian Parker (SPRU)
Martin Webber (PI), Tom Craig, Martin Knapp, Michael Dewey (Institute of Psychiatry, King’s College, London)
Patrick Gillespie, Nick Hervey (South London and Maudsley NHS Foundation Trust)
Jerry Tew (Institute of Applied Social Studies, University of Birmingham)
Sarah Carr (Social Care Institute for Excellence)
Michael Clark (NIHR School for Social Care Research)

Funder: The National Institute for Health Research, Programme Development Grant

Duration: January 2012 to December 2013

Background

Local authorities are required to offer personal budgets to all people eligible for ongoing social care by April 2013. Personal budgets provide service users with more freedom to purchase care and support from people they feel comfortable with, such as friends or family; or to fund activities to enhance well-being and promote social inclusion such as a gym membership, a college course or a taxi fare to a local library, for example. Direct payments are an alternative funding mechanism for personalising care and these are frequently used for one-off payments for specific items or services. However, only 6.5% of adult social care users received a personal budget or direct payment in 2008-9 and the take-up is particularly low among people with mental health problems.

Seventy-five Primary Care Trusts are currently piloting personal health budgets for people with long term conditions such as mental health problems to explore how the principles of personalisation may be extended into the NHS. However, there is limited evidence of the effectiveness of personalised care in mental health services.

Aims

Personalised care can comprise of a personal budget or direct payment, and self-directed support. It is important to have gold standard evidence of its effectiveness for people with mental health conditions. This project will carry out initial research to test the feasibility and inform the development of a full evaluation programme of personalised care.

The objectives of this development project are to:

• develop an exemplar of good practice in personalised care from the perspective of mental health service users, carers, clinicians and policy makers to inform the proposed programme grant
• review social and clinical outcomes in published evaluations of personal budgets, direct payments and self-directed support
• explore the acceptability and feasibility of undertaking a cluster randomised controlled trial of personalised care within NHS Mental Health Trusts
• explore ways of overcoming potential barriers to the success of the proposed research programme, including professional and service cultures that may be resistant to change
• evaluate the potential impact that merging personal health and social care budgets will have on the proposed programme
• further develop the plans for the individual work packages of the proposed programme.

Policy and practice aims

The personalisation of social care services and the imminent introduction of personal health budgets nationwide make it timely to evaluate the effectiveness and cost-effectiveness of personalised care in mental health.

Call for good practice examples

• We are keen to hear from you if you know of examples of personal budgets being used innovatively to meet the social needs or aspirations of people with mental health problems.
• We are interested to learn about practitioners empowering people to have genuine choice and control over their care and support in mental health services.
• We would like to know where the bureaucracy around personal budgets has been streamlined to facilitate the process.
• We also would like to hear about mental health services which have fully taken on board the principles of personalised care.
• In short, if you are a user of services, carer, practitioner, manager, commissioner or otherwise know of good practice in personalised care in mental health services, we would like to hear from you.

Please see the this pdf with further details or email Linda.parker@kcl.ac.uk with your details and information about the good practice that you want to share. Deadline for this information is 14th April 2012.

Many thanks,

Dr. Martin Webber

If you require further information about the project, please contact Martin Webber