It has been a while since I last posted about the Personal Health Budget (PHB) that I was applying for. To recap, there was a new mental health scheme in my area that was looking to give individualised budgets to help reduce a patients overall cost to the NHS (including things such as a&e visits and inpatient stays). After lots of different consultations with different professionals (my care coordinator, therapist, a person from the local commissioning group and a budget broker), a support plan was put together. This included having extra support around my therapy sessions so that I could go ahead with trauma work and also having a personal trainer so that I could restart my healthy ways in a safe environment (he works out of his own private studio so I wouldn’t have to go to a gym which is an issue).
In my original assessment, it was worked out that I had cost the NHS around £17,000 in the last financial year and so the budget set was 15% of this (£2,550 for a year). The aim of spending this money was to reduce the £17k cost and the plan we put together was an excellent one to reduce this. The problem was, it was going to cost around £8,000.
The application is taken to the local CCG funding panel (they agree local spending within the health budget) and the actual plan we had put together was agreed. The problem was the shortfall between the £2,550 and the £8k that was needed. Because of this, it was taken to a second panel and today I found out the results. They have rejected the difference and just given the £2,550.
I am extremely disappointed for a number of reasons. Firstly, this whole process has been going on since August. My therapy has been put on hold until this support had been put in place and so now I am 7 months behind. I don’t know what my therapist is going to say as she wanted the plan in place before she began the work. With £2,550, we can’t even put that support bit in place – they might as well have given a zero budget for the use it can be. And so I am left with the question, will my therapy be cancelled?
Secondly, I feel that the CCG have no real concept of the problems that people with mental health issues have and therefore are not willing to spend the money on us to give us a brighter future. I understand there are cuts everywhere right now, but by spending £8k, they would essentially be saving £9,000 in the year.
The measurable outcomes set against the budget were given as follows:
- reduction in care co-ordinator contacts
- reduction in home treatment team contacts
- reduction in incidents of self harm
- reduction in a&e attendances
- reduction in acute in-patient bed days
- positive changes in body mass index (BMI)
- improvement in ability to carry out everyday activities and to go outside more
- time spent per week doing changes in physical activity
Are they really serious? They expect all this on the measly sum of £2550? Do they truly understand the issues here, I don’t think so!
I don’t actually know what is next on my journey, I am having to sit with this for a while to digest it. We have spent 7 months saying this is the answer and it being a light at the end of the tunnel. It now feels like the light has gone out.