News / Limit direct payments, says confederation

Urgent and emergency care and elective procedures, which are already delivered through tariff, should not be part of personal health budget calculations, the NHS Confederation has insisted.

A pilot of direct payments for healthcare was among measures outlined in the health bill, which was published in January. The bill also paves the way for enforcement of the NHS Constitution, creates new quality accounts, and establishes the regime for unsustainable NHS providers.

 The NHS Confederation said personal health budgets could improve patients’ personal control, choice and empowerment, together with increased cost-effectiveness, but some issues had to be considered.

‘There are significant barriers that need to be overcome before this policy is rolled-out nationally: should patients be allowed to spend their personal budgets on non cost-effective treatments? Should individuals be allowed to top-up their care? Should patients be allowed to invest personal budgets to be spent at a later date?’ asked confederation chief executive Steve Barnett (Pictured above).

‘Any pilots should consider these issues in more detail. Personal health budgets could revolutionise the way in which care is delivered, but they are not without risks.’

In a briefing on direct payments, the confederation said it had found a consensus that urgent and emergency care, together with elective procedures already delivered through tariff, should be excluded from personal budget calculations. It said it will take time to understand personalised budgets and the costing associated with some service options, so it was best to exclude services where needs were unpredictable. There was a consensus that only predictable interventions, such as ongoing support for long-term conditions, should be included.

In guidance on the pilots, the Department of Health specifically excluded emergency care from the initiative.