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OPINION

'Initially I was sceptical about personal budgets, I thought - what's the catch?'

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Community Psychiatric Nurse, Ken, talks nurses’ personal budgets, integrating health and social care and best practice

Personal budgets might be new to some; I’ve been lucky enough to have been working with them for those three years. It’s all about performing a wider role as a nurse. It’s also about being a CPN and integrating health and social care because health needs have an impact on social care needs.

Personally, I got personal

Personal budgets were first suggested by my team leader; we at the Lincolnshire Partnership NHS Foundation Trust (lpft.nhs.uk) had a service user that he thought would be particularly suited to them. We saw the benefits for this person really quickly. We then started to use them for more and more people, who have mental health problems, who use our services. It was very exciting.

Latest research – that’s us!

Some of the work we’ve done in Lincolnshire – and work done elsewhere - has been captured by a Social Care Institute for Excellence report carried out by Acton Shapiro, NCIL and SPRU. 

The report presents findings from research into the experiences of using personal budgets for older people, people with mental health problems and their carers, with suggestions for good practice and future improvement.

How did service users respond?

Service users, a bit like me at the start, have approached the new system with caution and wondered what was ‘in the small print’. But they have often been staggered about their new experiences. They often trust in staff to know what works for them.

One of our service users used to end up in hospital a lot. Since he’s been on a personal budget, he’s not been admitted or had any crises. He knows that he’ll get the time with the support worker to do the activities that are bespoke for him. It’s working so far for him.

Further afield

It’s also really helped me in my training. I recently went to a similar service, but in a different part of the country with a service user from Lincolnshire. That was very powerful because those who were ‘personal budget refuseniks’ didn’t really have an answer to the evidence in front of them! However, I can identify with them if they are sceptical, because I was too! 

A new way of working

I used to be a day manager. I was proud of my work, but, looking back, some of it seems too institutional now. Everyone’s different. Take ‘group sessions”. I know that this works for some people but not for others. I can think of one service user in particular who has used their personal budget to join a ‘community group’. This is specifically NOT a mental health service user group but people with mental health issues can join the group. A difference that is subtle but very important. This has encouraged other service users to join the group. It helps, when perhaps a ‘prescribed’ group wouldn’t. There are loads more tips about how to get personal budgets right at the online SCIE pages.

Final thoughts

This is all so healthy and more inclusive. So, I’m cautiously enthusiastic rather than evangelical about personal budgets. There is concern about the recession and some organisations cutting back on some useful activities that people with personal budgets can take part in. But it’s important to look at the whole process. What is good is that we’ve tightened up on the link between assessing people and making sure they have good outcomes. I hate the phrase but some call it the ‘Golden Thread’.

What about personal budgets elsewhere in the NHS? That’s a big question! But in principle, yes; it’s important to get the process established. However, as I say, the starting point is to get the link right between needs and outcomes.

Keeping Personal Budgets Personal by the Social Care Institute for Excellenceis here. ReadSCIE’s blogon personal budgets.

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