By Jon Glasby

This report from the Health Services Management Centre, Birmingham University, argues for a system of personalised budgets in the NHS. The system would mirror direct payments introduced to social care in the late 1990’s allowing people to buy their own services and hire their own staff. Many expressed concerns about direct payments when they were introduced for social care, but the system has proved popular with users and has led to considerable creativity and innovation.

The report describes how the principal of providing the service to users with a budget could be applied to healthcare. Patients would have freedom to purchase services within the NHS or through private providers. Personalised budgets would also help fulfil government plans to give patients a greater say in their care and would help to remove some of the current funding inequalities in the NHS.

The authors envisage that direct payments in the NHS could initially be piloted in six areas including care for people with long term illnesses, mental health services and maternity services. This could potentially allow women to employ an independent midwife to manage their birth.

The report “Our Health, Our Care, Our Say – what could the NHS learn from individual budgets and direct payments?” is available on the Health Services Management Centre website. http://www.hsmc.bham.ac.uk