Antiretroviral medicines are used for the treatment of infection by retroviruses, primarily Human Immunodeficiency Virus (HIV).
UK AIDS statistics show that at the end of 2007 there were an estimated 77,400 people living with HIV in the UK. In 2007 an estimated 7,660 people were newly diagnosed with HIV, and the number is increasing by ten percent a year. Over half the people in the UK with AIDS/HIV live in London.
HIV patients whose conditions are stable can have their medicines delivered to them at home by van or postal delivery.
The London Specialised Commissioning Group (LSCG) commissions HIV services across London. The Pharmacy and Medicines Management Team worked with LSCG and NHS PASA to organise a tender for home delivery of antiretroviral medicines.
Savings are made by using home delivery as the medicines are not subject to VAT. The medicines are high cost, so the VAT savings cover the cost of the delivery and save on the cost of the medicines.
The first tender took place in 2005 for two years with an option for another two years. A further tender took place in 2008, with the contract starting in November 2008.
Since the project started the number of patients on HIV homecare has gone from around 300 to approximately 6,000.
Suppliers
Healthcare at Home, Evolution Homecare and Intecare Direct Ltd.
Benefits
The first contract from 2005 saved £2.2 million. The new contract will save £268,000. Trusts are allowed to keep 25 percent of savings made to support the additional cost of administering the home delivery system. Other benefits are
- Providing a more convenient service for patients
- Freeing up staff time for other HIV duties
- Reducing pressure on hospital pharmacies
- Improving contract management
- Running one procurement for London
http://www.lpp.nhs.uk/page.asp?fldArea=2&fldMenu=6&fldSubMenu=9&fldKey=104
PDF version Adult social care in England is "chronically under-funded" and "severely rationed", MPs say.
The Health Committee warned urgent action was needed and told the political parties to stop their point-scoring and seek solutions instead.
The cross-party group said if politicians failed they would "betray current and future generations".
Ministers are expected to set out their plans for reform of the £16bn system in the coming weeks.
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ANALYSIS
Nick Triggle, health reporter
The challenge facing social care is the perennial problem of supply and demand. While the NHS budget doubled in real terms over the last decade, social care funding rose by little more than 50%.
It has created a situation where councils have responded to more and more requests for help by restricting access to services, leaving vulnerable people to decide between struggling along on their own or selling their homes to pay for residential care. In truth, the social care system was only ever created as a safety net. The expectation was that a large proportion of caring would be done by relatives and friends, but with community and family life now very different from the 1940s that has become less likely. Politicians have responded by calling for a "partnership" between the state and individuals. That, of course, requires people to dip into their own pockets, creating an explosive issue in the run up to the election. |
Social care, which includes support provided by councils to people in their own homes for things such as washing, eating and dressing as well as residential home placements, is now at the top of the political agenda.
Last summer the government put forward three options for change - one of which involved charging people a compulsory levy of up to £20,000, which has been dubbed a death tax by the Tories.
In recent weeks, the row has escalated with the parties launching attacks on each others' policies.
Two summits have been held in the last month alone, but still no consensus has been reached.
But the committee said it was essential agreement was brokered early in the next parliament so as not to "betray current and future generations".
The report said reform was long-overdue, pointing out it is 13 years since Tony Blair announced changes would be made.
In that time, councils have been placing more and more restrictions on who can get access to care.
Three quarters of the 152 local authorities with responsibility for care now only provide services to those with the highest needs.
Costs
What is more, the means-tested threshold, which stipulates that anyone with assets of more than £23,000 has to pay for their care, was unrealistic, the MPs suggested.
They point out that the actual cost of care on average, certainly of care homes, was much higher.
And without reform, the situation is only going to get worse because of the ageing population, the MPs said.
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WHERE THE PARTIES STAND
Labour - Put forward three proposals - all of which involve the state providing a basic level of care which would be topped up by either personal contributions, a voluntary insurance scheme or compulsory levy. The third option - dubbed a death tax - is said to be favoured by ministers
Tories - Proposed an £8,000 voluntary insurance model to cover residential care costs. Now drawing up plans for a voluntary scheme to cover domestic care, such as help washing, eating and dressing in the home
Lib Dems - Initially supportive of free personal care - like Scotland has introduced - but now want a "partnership" whereby state pays some and individual tops this up. Open to compulsory levy
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However, they pointed out that the baby-boomer generation will not hit their mid 80s until the early 2030s, creating what they claimed was a "window of opportunity" to improve the system.
Committee chairman Kevin Barron added: "We don't want this issue to be turned into an election football for it to be kicked back into the long grass again in a few weeks."
And as an interim measure, while the system is being reformed, he said the £23,000 threshold should be raised so that more people could get access to care.
Mr Barron also said general taxation should not be ruled out as a way of funding social care - all the options being considered at the moment involve some state funding, coupled with individual contributions.
Stephen Burke, of Counsel and Care, a charity for older people, said: "This sets out in clear terms why we need reform. The three parties now need to meet the challenge."
Care services minister Phil Hope said a white paper setting out how the system should be changed and funded in the future would be published soon.
He added: "Fixing our system of care for people who are older and disabled is our very highest public service priority."
Political parties should set aside "pre-election point scoring" over the issue of social care for the elderly in England, a committee of MPs has said.
A report by the cross-party Commons health committee says a consensus is needed for a long-term strategy to be drawn up concerning those needing care.
It calls for a start on planning of a National Care Service, whether funded by tax or an insurance scheme.
The government is expected to publish social care plans before the election.
The committee said a failure to reach a consensus on delivering reforms would "betray current and future generations".
All the main parties are looking at ways to end the complex series of rules and local assessments that decide if someone gets funding for their care in old age or must spend their own savings, which in some cases involves a person selling their home.
The report was critical of the government's Personal Care at Home Bill.
The bill, which is currently going through Parliament, was announced by Gordon Brown at Labour's conference last autumn in the middle of a consultation period on wider reforms to set up a National Care Service.
'Lasting solution'
The MPs were sceptical about an unexpected pledge by the prime minister that 400,000 people would get free care at home - a measure that would be introduced before the wider reforms being considered.
The report called that "policy-making on the hoof".
It said there was a strong argument for reform of the current system, which "provides a safety net service rather than a universal one, is chronically underfunded and is insufficiently focused on the needs and aspirations of individual people".
However, it added: "Worthwhile and lasting reform will only be achieved if consensus can be reached... so that the necessary tough decisions can be taken with broad popular support.
"We would have liked to see all the political parties come together to map out sustainable reform, instead of indulging in pre-election point-scoring. There is still an opportunity in advance of the demographic changes to come to reform social care, achieving consensus and creating a lasting solution."
Kevin Barron, the committee's chairman, said the MPs did not want the issue "to be turned into an election football for it to be kicked back into the long grass again in a few weeks".
A two-track approach could see each generation paying its own costs of care in later life.
Our present system of paying for care needs replacing. The big sticking point is finding extra funding which both covers the growing needs of an ageing population and shares the cost fairly between generations. This viewpoint:
- proposes a phased two-track approach, with an initial charge on inheritance being gradually replaced by funds built up through extra National Insurance paid by younger age cohorts.
- suggests such a broad sharing of costs among different generations, linked to ability to pay, could be presented as a fair and equitable settlement.
Can we create a fairer adult social care system?
The recent Green Paper shows that the Government has moved on from previous statements on adult social care – but it still lacks important detail, particularly on funding options.
In this Viewpoint, Justin Keen (Professor of Health Politics) and David Bell (Professor of Economics) evaluate the Paper and ask the following questions:
- Is the Government taking steps to ensure that arrangements for the care and support of older people are fair?
- Is the Green Paper detailed enough to determine whether people on different incomes may 'win' or 'lose' under any new set of proposals?
Too many people in England receive poor quality out-of-hours doctors' services, the Patients Association has warned.
In some areas, a fifth of patients described the service as "poor" or "very poor". Some 1.1m patients responded to the government survey.
Richmond and Twickenham and Hartlepool were among the poorest, with Central Lancashire and Plymouth among the best.
Ministers have given trusts until the end of the year to follow strict new guidelines on out-of-hours care.
And campaigners have described the current system of providing after-hours GP cover as "an accident waiting to happen".
The survey follows the death, in 2008, of 70-year-old David Gray, who died after he was treated by a German doctor with no experience as an NHS GP.
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PATIENTS' WORST SIX
Richmond and Twickenham
Hartlepool
Ealing
Hounslow
Tower Hamlets
Harrow
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Dr Daniel Ubani, who spoke poor English and who was exhausted after commuting hundreds of miles from his home in Germany, had been employed by a private company to provide emergency out-of-hours cover.
He gave 70-year-old Mr Gray an overdose of diamorphine and was later described as "incompetent by a coroner who also called for the reform of the out-of-hours care system.
In 2004, the overwhelming majority of GPs across the UK gave up responsibility for organising out of hours care when a new contract allowed them to opt out.
'Accident waiting to happen'
The study saw some 2.8m survey forms distributed with a response rate of 40%.
It found that Richmond and Twickenham Primary Cary Trust had the worst out-of-hours care, with 21% of patients saying the service was poor or very poor.
Hartlepool was next, with 20%.
However, in Central Lancashire, 72% said the service was good or very good, while 77% said the same in Plymouth.
Across England as a whole, 65% of those who had used the service in the past six months said their out-of-hours care was good or very good, while 13% regarded it as poor or very poor.
But of those who had been prescribed or recommended medicines by out of hours GPs, 15% said they found it not easy or not at all easy to get hold of the drugs.
And some 35% of all those who took part in the survey said they did not know how to contact their GP out of hours.
In many areas, new contracts for evenings and weekends were taken up by private companies, although GP collectives also run some services.
Kieran Mullan of the Patients Association said ministers should do whatever was necessary to ensure that promises made nationally were delivered locally.
He told the BBC
: "We know that the primary care trusts aren't doing a good job in all cases and I think that the government have to take some responsibility for ensuring that they do."
Peter Walsh, of Action against Medical Accidents, said in some areas the system is not fit for purpose.
He told the BBC: "We have adults with strokes, heart attacks where the symptoms haven't been recognised.
"The system we have at the moment is an accident waiting to happen we are fortunate that we have not had more incidences than we have had so far."
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 There is nothing to suggest there aren't other doctors like Dr Ubani, the doctor that killed my father in the system 
Dr Stuart Gray
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Health Minister Mike O'Brien told the BBC provision is still too patchy and that patients need to know their doctor is competent.
He said: "There are a whole series of steps being taken, I'm not satisfied its good enough yet.
"I want by the end of this year, no longer, for it to be good enough for me to know that if I or you call out an out of hours doctor they are competent and they won't kill somebody."
The NHS confederation which represents Primary Care Trusts accepts the system had serious failures, but says most out of hours services do a good job most of the time, and they say new guidelines and practices are improving the quality of out of hours care.
But Dr Stuart Gray, a GP and Mr Gray's son, said he was not convinced the system had been fixed.
He told the BBC: "There is nothing to suggest there aren't other doctors like Dr Ubani, the doctor that killed my father in the system, inadequately trained and unable to converse in English, at this moment in time delivering out of hours care in this country."
FOI results from 90 Trusts reveal that the average spend per head of the registered patient population was £9.00 but there was significant variation with the lowest spending less than £1.50 and the highest over £20.00.
Director of the Patients Association Katherine Murphy said “These figures aren’t an exact science. There will be some PCTs that didn’t do a very good job of negotiating their contracts or calculating what the service really costs them. Some PCTs will have large rural populations which can be more expensive. But common sense would tell you that this degree of variation is worrying - it is hard to understand how one PCT might be spending 16 times more on out of hours care than another. Similar variations were also found in research conducted by the Primary Care Foundation. It is vital that the Department of Health press on with reform in this area so we can have a much better idea of what service is being provided for what money. Participation in benchmarking must be mandatory and the results published as soon as possible. Then we’ll be more able to say what value for money is and when PCTs are scrimping on such a vital service. Local scrutiny is only effective if you know how well your local services are performing.”
Analysis of the results of the GP National Patient survey reveals that for the first two quarters of 2009/10 that in over a fifth of Trusts (33) 1 in 6 patients rate out of hours care as either poor or very poor. This represents an increase from the 2008/2009 results (30) though comparisons are limited due to different survey methodologies.
PA Director Katherine Murphy said “Once again, there is huge variation with more than double the number of patients rating the service as poor or very poor at the bottom of the table compared to the top. This is completely unacceptable. The postcode lottery of care has to stop.”
The Patients Association also asked Primary Care Trusts to tell us how many complaints their providers had received and how many Serious Untoward Incidents (SUIs) there had been related to out of hours care. 5 Trusts were unable to tell us how many complaints there had been and 3 were unable to tell us how many SUIs there had been.
Members of the House of Lords contributed to the report stage - further line by line examination - of the Personal Care at Home Bill on 17 March.
Clauses 1 and 2 were discussed on topics covering a delay in the starting date for the new legislation, allowing the Bill to lapse if it does not come into force, and an independent review of the costs involved.
- Video & Audio: watch the debate on the Personal Care at Home Bill
- Lords Hansard: read the debate on the Personal Care at Home Bill
Votes on amendments to the Personal Care at Home Bill
View the results of the four votes on amendments to the Personal Care at Home Bill on our Divisions Analysis tool:
- Results of the first vote on the Personal Care at Home Bill
- Results of the second vote on the Personal Care at Home Bill
- Results of the third vote on the Personal Care at Home Bill
- Results of the fourth vote on the Personal Care at Home Bill
The Government was defeated on all four amendments.
Third reading - the final tidying-up of the Bill in the Lords - takes place on 24 March.
Further information
- Parliament News: Personal Care at Home Bill: day two of Lords committee stage
- Personal Care at Home Bill
- Passage of a Bill: Report stage (Lords)
http://news.parliament.uk/2010/03/personal-care-at-home-bill-lords-repor...
The government’s End of Life Care Strategy set out to improve the care that patients receive at the end of their life and to give them meaningful choice about where they are cared for and where they die. Implementation of the strategy has proved challenging, however, for a number of reasons: death and dying remain taboo subjects; the number of people dying is rising, putting extra pressure on end-of-life care services; budgets are likely to be limited in the coming years.
To help those who have responsibility for implementing the strategy, The King’s Fund organised the Sir Roger Bannister Summit at Leeds Castle in November 2009 at which senior policy-makers, clinicians, managers, officials and academics could share the challenges and suggest practical solutions.
Delivering better care at end of life: the next steps includes papers given at the summit – covering issues including commissioning, hospice and hospital care, quality markers, challenges for providers – and an account of the debate generated. It identified 10 critical actions to help the successful implementation of the strategy. It should be invaluable for those seeking to improve the quality of the care offered to patients at the end of life.
http://www.kingsfund.org.uk/publications/leeds_castle_eolc.html
The Minister of State, Department of Health (Phil Hope): The Department has today published the consultation document—“Personal Care at Home: a consultation on proposals for regulations and guidance”.
The Personal Care at Home Bill, published today, contains new proposals costing £670 million, which are the Government’s first step towards setting up a new National Care Service—a simple, fair and affordable care system for everyone.
Subject to parliamentary approval, from next October, older people and younger disabled people will be better helped to live independently for longer in their own homes—something they tell us they really want.
The Bill guarantees free personal care for the 280,000 people—including those with serious dementia or Parkinson’s disease—with the highest needs. Some of those already get free care—this Bill will protect their savings from future charges. Others will get free care for the first time. We will also help around 130,000 people who need home care for the first time to regain their independence.
This intensive help or “re-ablement” will help people to regain their independence and prevent ill health. This means people will maintain their dignity and rebuild their confidence so that they can live at home for longer. Helping people to stay in their own homes could involve adapting their homes.
New equipment installed in people’s homes to help them stay there could include electronic pill dispensers or movement activated alarms using the voice of a grandchild to remind an elderly person to close the door, for example. Helping people to stay in their own homes and adjust their living conditions so they can stay safely, puts prevention at the heart of the system.
The consultation covers three main areas:
what should be contained in the regulations made under the Bill;
what should be contained in the guidance accompanying the regulations; and
suggests three ways of allocating funding to councils.
The consultation document has been placed in the Library and copies are available for hon. Members from the Vote Office.
http://www.publications.parliament.uk/pa/cm/cmtoday/cmwms/archive/091125...
HIV Homecare – the London Experience
Philip Aubrey
Medicines Procurement Specialist – London & East of England
LPP – P&MM Operational Lead
National Homecare Symposium - 15th January 2009
Overview
- Commissioning of HIV services in London
- Background to HIV homecare in London
- Tendering for a London HIV Homecare Service
- Retender of London HIV Homecare 2008
- Outcome of London HIV Tender 2008
Commissioning of HIV services in London
- The London HIV Consortium manages the overall commissioning and provision of HIV services across London
- London Specialised Commissioning Group (LSCG) manage the commissioning of HIV services from the 31 PCTs to the 24 HIV provider trusts across London
- 2007/08 budget - £211m (65% on ARVs)
- Growth in activity - 7.6%
Background to HIV homecare in London
- In 2004/05 - the HIV Consortium decided that London HIV patients should be offered the opportunity to receive their antiretroviral therapy through a home supply arrangement.
- This followed previous experience at the Royal Free Hospital who at the time had 380 patients on HIV homecare.
- Other London trusts with HIV homecare activity – UCLH, GOS and C&W.
Background to HIV homecare in London
-
Drivers:
- Provides patient choice
- More convenient for some patients
- Patients can choose between their medicines being delivered by van or via the post
- Frees up NHS staff time for other HIV duties
- Removes a burden from already overloaded hospital pharmacy dispensaries
- Financial benefit as medicines are VAT exempt
Tendering for a London HIV Homecare Service
- Agreement of stakeholders on how to construct tender
- Design of tendering model
- NHS PaSA to undergo tender on behalf of the London HIV Consortium
- Specification of tender – used NHMC original specification
- No of patients eligible
- Homecare market intelligence
- From Royal Free model 25% of patients on treatment should be eligible for homecare
Stakeholders
Commissioners
Patient – Public
Engagement
(PPE)
Clinicians
HIV
Pharmacists
Procurement
Pharmacists
NHS PaSA
HIV Consortium
Prescribing
Advisor
Senior
Pharmacy
Managers
HIV
nurses
London
HIV
Homecare
Tender
Design of Tendering Model - 2005
- Framework contract
- Suppliers are invited to price for a van or postal delivery depending on the number of patients they have on service
- Patient bandings
- 3 monthly supply of patient medication (4 deliveries per year)
- List A – ARVs (pan London contract prices)
- List B – miscellaneous (source at lowest cost)
- Suppliers must provide financial data to LSCG on a monthly basis
London HIV homecare contract - 2005
- Commenced 1st July 2005
- Duration - 2+2
- Awarded to 4 suppliers
- Each supplier awarded geographically:
- HaH – North Central London (except UCLH)
- Firstplus – North West London (except C&W)
- HCL – North East London
- Intecare – South London
-
Note – Firstplus – terminated contract in Mar 07
London HIV homecare contract - 2005
- Homecare suppliers buy ARVs at list price
- They then provide manufacturers with dispensing data
- Manufacturers reimburse homecare suppliers difference between list price and contract price
- Provider trusts are allowed to keep 20% (now increased to 25%) of any savings to fund infrastructure costs
Retender of London HIV Homecare 2008
- Similar model to 2005
- Homecare suppliers invited to price (van and postal) on patient numbers up to 6000+ in bandings of 500 for 3, 4, 5 or 6 monthly deliveries
- Evening, weekend and emergency delivery prices were also requested
- Patient numbers on therapy are confirmed by the trusts
Example of pricing by patient banding
Retender of London HIV Homecare 2008
- New NHMC specification used for tender
- Suppliers were requested to supply monthly management information and KPI data to PaSA
- Pre-tender meeting with all homecare suppliers – 8th May 2008
- 6 suppliers submitted tenders
- Shortlisted to 5 after PQQ
Retender of London HIV Homecare 2008
- Tenders were scored using the eAward system by myself, NHS PaSA and 2 HIV Pharmacy Leads
- Final adjudication – 1st Aug 2008.
-
Adjudication panel consisted of:
- Procurement pharmacists
- NHS PaSA
- Prescribing Advisor to HIV Consortium
- Patient – Public Engagement representative
- Commissioners
- HIV Pharmacy Leads
Weightings
Measure
Weighting
Homecare supplier infrastructure
20
Quality Assurance
12
Storage and distribution
20
Customer service
18
Price
30
Total
100
Outcome of London HIV Tender 2008
- Awarded the existing 3 homecare suppliers to the framework
- This was mainly due to higher service charges from the other two tenderers
- New patients in Supplier A trusts will commence with Supplier B
Percentage market share of London HIV homecare patients by supplier
London HIV Homecare Savings
Year
Saving
2005-2006
£999,020
2006-2007
£1,200,488
2008-2009
£268,609
Overview
Antiretroviral medicines are used for the treatment of infection by retroviruses, primarily Human Immunodeficiency Virus (HIV).
UK AIDS statistics show that at the end of 2007 there were an estimated 77,400 people living with HIV in the UK. In 2007 an estimated 7,660 people were newly diagnosed with HIV, and the number is increasing by ten percent a year. Over half the people in the UK with AIDS/HIV live in London.
HIV patients whose conditions are stable can have their medicines delivered to them at home by van or postal delivery.
The London Specialised Commissioning Group (LSCG) commissions HIV services across London. The Pharmacy and Medicines Management Team worked with LSCG and NHS PASA to organise a tender for home delivery of antiretroviral medicines.
Savings are made by using home delivery as the medicines are not subject to VAT. The medicines are high cost, so the VAT savings cover the cost of the delivery and save on the cost of the medicines.
The first tender took place in 2005 for two years with an option for another two years. A further tender took place in 2008, with the contract starting in November 2008.
Since the project started the number of patients on HIV homecare has gone from around 300 to approximately 6,000.
Suppliers
Healthcare at Home, Evolution Homecare and Intecare Direct Ltd.
Benefits
The first contract from 2005 saved £2.2 million. The new contract will save £268,000. Trusts are allowed to keep 25 percent of savings made to support the additional cost of administering the home delivery system. Other benefits are
- Providing a more convenient service for patients
- Freeing up staff time for other HIV duties
- Reducing pressure on hospital pharmacies
- Improving contract management
- Running one procurement for London
http://www.lpp.nhs.uk/page.asp?fldArea=2&fldMenu=6&fldSubMenu=9&fldKey=104
Personal Budgets - a new way to get help!
Personal Budgets are a new way for people who need social care and support services to have greater choice and control over the services they receive.
Personal Budgets put you at the centre of everything, making sure the services you receive help you achieve the things that are most important to you.
What is a Personal Budget?
A Personal Budget is a sum of money from Community Care Services (Social Services for adults) offered to people who need a lot of help to stay independent, safe and well.
You can use this money to choose the support you need to stay independent, safe and well.
A Personal Budget can be used instead of, or in combination with, services such as Home Care or a Day service.
You do not have to use your Personal Budget if you do not want to! If you are happy with the services you receive and they are meeting your needs, you do not need to change them.
Why choose a Personal Budget?
People who have a Personal Budget say it gives them more say in their life.
With a Personal Budget you can choose who will provide you with the support you need and how they will provide it!
Who can get a Personal Budget?
Anyone who lives in the Royal Borough of Kingston who needs a lot of help to keep independent, safe and well, can get a Personal Budget.
This includes, for example -
- Older people
- Disabled people
- People with a sensory impairment
- People with learning disabilities
- People with mental health needs
- People with HIV
- Family and friends (carers) supporting someone to keep independent, safe and well.
How can I get a Personal Budget?
Before you can get a Personal Budget we will need to talk to you about the kind and amount of support you need. This is called an assessment. You will be fully involved in this.
You can even choose to carry out your own assessment if you want to, or get the help of one of our staff, or another person.
If you write your own assessment it will need to be agreed by us.
Your assessment will decide if you can get a Personal Budget and how much money you will be offered to choose the support you need.
Once your assessment has been agreed, we will ask you to produce a support plan showing how you will use your Personal Budget. You can write this yourself or get help from one of our staff to write it, it’s your choice.
What can I use the money for?
There are lots of different ways you can use the money to help you keep independent, safe and well, including -
- Employing a personal assistant or support worker to help you with your personal care or daily living tasks
- Buying services such as personal care from an agency
- Taking a break
- Buying equipment such as a computer, a page turner or a personal alarm
- Paying for an adult learning class
- Buying gym membership to improve your health
- Paying for adaptations to your home to make it easier for you to live in.
What can't I use the money for?
There are a number of things you cannot use the money for. You cannot use the money, for example, to -
- Buy things that do not improve your life
- Gamble
- Do anything illegal.
Will I have to contribute to my Personal Budget?
You will have to pay a contribution towards your Personal Budget. Your contribution will depend on the amount of money you have coming in, your savings, and your financial circumstances.
Depending on your financial circumstances, we may be able to reduce or waive your contribution. We can help you to apply for any welfare benefits you may be entitled to. You will not have to pay for any information or advice we offer you or for the assessment of your needs
How does a Personal Budget work?
A Personal Budget can work in a number of ways. You can choose to -
- Have it as a cash payment to arrange and pay for your own support
- Pay it directly to the service providing support for you
- Have the Council arrange and pay for services for you
- ‘Mix and match’ Personal Budgets and services!
- It’s your choice!
Can I get help to organise my Personal Budget?
You can get as much or as little support as you want and need to organise your Personal Budget.
You can get help to do all of these things from one of our staff, a family member, a friend or an independent organisation or advocate.
You can do it yourself or get help to -
- Work out what support you need
- Make a support plan setting out how you will use your Personal Budget
- Look after and use your Personal Budget, and
- Review how things are going.
Related Documents:
Get help accessing files or request files in alternative formats
-
'Personal Budgets - Living your life your way' - Leaflet
- 'Personal Budgets - Living your life your way' - Podcast (mp3 file 2.09Mb) - podcast of the leaflet.
http://www.kingston.gov.uk/browse/health/communitycareservices/personal_...
Self-directed support: direct payments, personal budgets and individual budgets
http://www.ageconcern.org.uk/AgeConcern/Documents/FS24Self_directed_supp...
Care Trusts
The Panel is currently considering whether to issue joint guidance with the Health Panel on Accountability Frameworks for Care Trusts following the recent 'Emerging Framework' document (see below) issued by the Department of Health (DH)
Direct Payments
The Panel is also considering a review of this guidance that was last issued in 1997.
Fairer Charging Policies for Home Care and Other Non-Residential Social Services
The Panel submitted comments on the above DH consultation paper in March.
Full details of the response are available on the CIPFA website.
Free Nursing Care
There is provision in the Health & Social Services Bill, currently passing through Parliament, for free nursing care to take effect in nursing homes from 1 October 2001.
The Panel is awaiting the outcome of the Bill to assess whether to issue guidance for practitioners in Social Services.
Introduction to Social Services Finance
The Panel is currently considering a review of this guidance following the success of this publication in 1999.
Neighbourhood Initiatives/Supporting People
A bulletin on this subject is planned to be issued in Summer 2001
Pooled budgets
A joint publication by CIPFA's Health and Social Services Panels was published in March providing guidance on the establishment and management of pooled budgets and:
There are six sections in the guide that look at the following different elements of pooled budgets for partnerships
A checklist is provided to assist implementation and Department of Health guidance (extracted from the Health Act 1999) is also included.
The guidance has been produced in conjunction with the Department of Health and provides essential guidance for practitioners and organisations as they develop partnership arrangements under the Health Act 1999.
Copies of the publication may be ordered from www.cipfa.org.uk/shop
FUTURE CIPFA EVENTS
Pooled Budgets
6 July 2001, London
Following the initial event on 26 April being
over – subscribed this event is being re-run
This one day event for NHS and Local authority finance and non-financial staff who are involve in the establishment and management of a
pooled budget that will complement the recent CIPFA publication.
High-level speakers will address the following themes
and there will be the practical experience of two case studies.
Please visit the Professional and Technical page on the CIPFA website for further details or contact Alex Aarons, Courses Co-ordinator, CIPFA, 3 Robert Street, London, WC2N 6RL (tel. 020 7543 5751) or e-mail alex.aarons@cipfa.org
Social Services Finance: Current Developments
Autumn 2001, London
A special two-day event addressing a range of current developments in Social Services finance and the spectrum of performance measurement and management issues facing this sector of local government.
For further details contact Alex Aarons, Courses Co-ordinator, CIPFA, 3 Robert Street, London, WC2N 6RL (tel. 020 7543 5751) or e-mail alex.aarons@cipfa.org
DEVELOPMENTS IN SOCIAL SERVICES FINANCE
Care Trusts
The Health and Social Care Bill that is currently passing through Parliament confirms that new combined Care Trusts will be set up to act as single bodies responsible for all local health and social care. The Department of Health has recently issued a document 'Care Trusts – Emerging Framework' that considers the ways in which the Care Trust policy is being designed and developed.
Further details are available on www.doh.gov.uk/caretrusts
Community Equipment Services
LAC (2001) 13 outlines action for local authorities and NHS organisations to spend the large amount of new investment announced for these services, and to work towards the NHS plan targets of
Further details are available on www.doh.gov.uk/coinh.htm
Intermediate Care
LAC (2001) 1 provides guidance on the definition and lists five criteria that have to be met.
New NHS funds (£405m by 2003-4) announced in the NHS Plan, and clarified in this guidance, are specifically earmarked in this guidance.
Further details are available on www.doh.gov.uk/coinh.htm
Mental Health Grant
LAC (2001) 05 sets out the conditions attached to the core grant and individual Councils with Social Services Responsibilities allocations.
More details are available on www.doh.gov.uk/coin.htm
National Service Framework for Older People
LAC (2001) 12, published in March sets national standards and defines service models to tackle age discrimination and drive up the quality of care of older people in all settings across social services and health.
Further details are available on www.doh.gov.uk/nsf/olderpeople.htm
New Promoting Independence Grant
The new grant will have broadly similar aims and conditions to the Partnership and Prevention grants that it replaces from 2001/02.
A summary of the main aims and conditions of the new grant can be found on www.doh.gov.uk/scg/independencegrant
Power to promote or Improve Economic, Social or Environmental Well-being
The DETR published guidance on the new power from Section 2 of the Local Government Act 2000 in March.
Copies of the guidance can be downloaded from the DETR website www. local-regions.detr.gov.uk/wellbeing/index.htm
Residential Care Homes and Nursing Homes
From 9 April the capital limits to be used for in calculating income related help with health costs through the NHS Low Income Scheme for permanent residents will be the same as those already notified by Social Care Group for the means-test for residential accommodation, ie £11500 and £18500.
From the above date capital limits for non-permanent residents are the same as for income support, ie £3000 and £8000 for those under 60, and £6000 and £12000 for those 60 and over.
Free explanatory booklet available from www.doh@prolog.uk.com
Support Grant for Social Services for People with HIV/AIDS
LAC (2001) 3 explains arrangements for continuation of the above grant in 2001/02. Local authorities are also invited to bid for a Supplementary Credit Approval for HIV/AIDS
related housing projects.
Further details are available on www.doh.gov.uk/coinh.htm
Supporting People – Policy into Practice: Reminder
The DETR alongside the DH is urging all local agencies to work together during the implementation phase. Funding for these support services will be brought together and placed into a specified grant paid by the Government to be administered by local authorities in partnership with NHS bodies and the probation service from April 2003.
Policy and Practice is available on www.supporting-people.detr.gov.uk
Unaccompanied Asylum Seeking Children's grant
The Home Office has written to all Directors of Social Services in England inviting them to claim the above grant for 2000/01.
Copies can be obtained by e-mailing ann.burke@homeoffice.gsi.gov.uk
Valuing People: A New Strategy for Learning Disability for the 21st Century
The recently published White Paper sets out a major programme designed to improve life chances for people with learning disabilities.
The White Paper is available from www.official-documents.co.uk
http://www.cipfa.org.uk/panels/social_care/show.cfm?news_id=9493
Community Care Services for people living at home Charging Policy
The Independent Living Fund has barred disabled people from applying for its care payments for the rest of 2010-11 to stave off a funding crisis.
The ILF announced the decision today, just three months after it unveiled controversial plans to restrict new applications to disabled people in work.
That decision sparked fury from disabled activists and the Scottish government, while council leaders said the restriction would shunt costs onto local authorities, as they would have to fund full care packages for people who would previously have been eligible for ILF support.
The ILF's latest move is likely to provoke further, and possibly greater, anger.
It said that it would be able to help 600 new service users who had already applied for funding in 2010-11, but otherwise it would have to focus its £359m budget on its 21,000 existing users.
ILF chief executive Patrick Boyle said: "Our first priority is the 21,000 disabled people we currently support to achieve high quality independent lives. Our trustees have acted quickly in their decision and to meet their responsibility to manage within budget."
The fund said it was writing to all applicants and existing users to inform them of the news and would be "continuing its dialogue" with councils, disabled people's organisations and others.
Related articles
Adass and LGA warn of extra council costs from ILF cut
Independent Living Fund defends funding restriction
http://www.communitycare.co.uk/Articles/2010/06/18/114738/ILF-closes-doo...
The Independent Living Fund (ILF) has taken further steps necessary as care package costs rise, to protect its existing users and manage within its allocated budget for 2010-11.
In order to safeguard existing users' awards, the ILF will not be accepting any new applications for the remainder of the year, and is unable to make any further awards, except those they have already agreed to fund. The ILF will be able to help some 600 new ILF users in this financial year as a result of offers of funding already made.
The measures will ensure that the existing 21,000 ILF users' awards continue at their current level. However, the ILF cannot afford to increase individual awards above the amount already paid, other than additional support to meet some of their employer responsibilities, and in response to certain changes in their income.
Explaining the position, Patrick Boyle, ILF Chief Executive, said, "Our first priority is the 21,000 disabled people we currently support to achieve high quality independent lives. Our Trustees have acted quickly in their decision to protect this group and to meet their responsibility to manage within budget.
"We are committed to continuing and developing the excellent service we deliver to our users, allowing them greater flexibility in how they choose to manage their funding."
The ILF is writing to all applicants and existing users to make them aware of these latest steps and is continuing its dialogue with local authority partners, disabled people's organisations and others.
ENDS
Notes to editors
For more information contact Jennie Bush on 0115 9450741 or 07772 770840.
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The Independent Living Fund (ILF) is an Executive Non-Departmental Public Body of the Department for Work and Pensions. It awards payments to severely disabled people to support the cost of their personal assistance, enabling them to live fully inclusive independent lives in their communities. To get payments from the ILF you have to meet certain conditions.
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The ILF provides financial assistance under the terms of a single publicly financed discretionary Trust Deed - The Independent Living Fund (2006), governed by a Board of nine Trustees.
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The ILF currently provides financial support to over 21,000 disabled people in the UK, and has supported over 46,000 disabled people during the last 21 years.
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The measures taken to manage within available funding are based on an allocated budget of £348m for Great Britain and £11.2m for Northern Ireland.
- Visit www.ilf.org.uk for more information about the Independent Living Fund.
http://www.ilf.org.uk/news/new/ilf_protect_users_awards_to_manage_within...
http://www.publications.parliament.uk/pa/cm200910/cmhansrd/cm100225/text...