Investigation by medical publication uncovers unusual uses of some personal health budgets approved by local NHS teams

This article is more than 5 years old

This article is more than 5 years old

NHS patients have gone on holidays and been provided with Wii games consoles, a summer house and a pedalo ride under a scheme to give patients in England personal health budgets, an investigation has found.

A satnav, a vacuum-cleaning robot, shiatsu massage and horse-riding are among other items or pursuits funded through the scheme that is designed to give patients more control over their care.

All patients needing continuing healthcare in their home or in residential care are entitled to have personal budgets to give them more control over the help they get from the NHS. The budgets must be agreed with local NHS teams.

An investigation by the medical publication Pulse, aimed primarily at GPs, has uncovered unusual uses to which some funds were put last year.

Freedom of information requests to clinical commissioning groups (CCGs) suggest they intend to spend more than £120m this year on personal budgets for 4,800 patients.

Details from 33 of the 209 CCGs on what they funded last year show that £267,000 was spent on five individuals by Kernow CCG, which covers Cornwall and the Isles of Scilly. Of that, £2,080 was spent on aromatherapy, £248 on horse-riding and £7.34 on pedalo hire.

A spokesperson for NHS Kernow said: “A small number of people have taken up personal health budgets in Cornwall to meet their agreed health outcomes, aligned to their assessed health needs. We follow national guidance when agreeing personal health budgets.”

In Stoke, Staffordshire, a patient had music lessons at £20 a week, costing more than £1,000 for the year, and two patients were provided with Wii Fit machines.

The CCG said the music lessons had been requested by the local mental health team and “contributed to the patient requiring less support” from the NHS.

It added: “A Wii Fit was authorised for one patient at a cost of £208 at the request of the pulmonary rehabilitation team. This allowed them to carry out rehab at home until the need for rehab ended and was considerably less costly than the main alternative, which is gym membership.”

Stoke’s statement added: “One further patient was provided with a Wii Fit Plus at a cost of £79, also for pulmonary rehabilitation.”

All the cases “were judged to help the patient and represent excellent value for the NHS”.

The Corby and Nene CCGs in Northamptonshire provided budgets to 161 patients at a cost of £2.6m, including family holidays, shiatsu, personal trainers, new clothes and building a summer house.

Sheffield CCG spent £4.6m on 174 patients, largely on domiciliary care or personal assistants, but said the personal budgets had not cost more than services paid for in a more traditional way.

The three CCGs for Horsham, Crawley and Coastal West Sussex together spent £2.6m on 44 patients last year, the highest spend per individual.

Richard Vautrey, deputy chair of the British Medical Association’s general practitioners’ committee, told Pulse the personal health budgets could have a big impact on existing services. “Quite often they are working within limited margins and so loss of even a small amount of their income can jeopardise a whole service. This can have serious implications for large numbers of people just based on the whims of a small number.”

Nick Watson, a professor of health and wellbeing at Glasgow University, said the scheme was “consumerist” and based on poor evidence.

Pulse’s editor, Nigel Praities, said: “It is easy to see that a holiday or a summer house could have a powerful effect on an individual’s wellbeing, but can the NHS really afford these luxuries at a time of austerity?”

The Department of Health said: “It’s right in some cases that patients with chronic ongoing health needs should be able to take decisions about their own care to help improve their quality of life, and personal health budgets can do just that.”

Its statement added: “Anything bought using this budget has to be agreed with a health professional, signed off by the local NHS and show clear evidence of improved outcomes. Personal health budgets are cost-neutral and therefore do not represent taking anything away from the public purse.”

NHS England said an independent evaluation led by the personal social services research unit at Kent University had “shown personal health budgets are cost-effective, help people manage their health and improve quality of life”.

Separately, NHS England will on Tuesday order the service to “cut the unnecessary reliance on paper”. All CCGs must have plans in place by next April to switch to a completely electronic system in recording treatment of patients across all health and care services by 2020.

From October, all discharge summaries for patients released from acute hospitals and daycare to the care of their GP must be sent electronically. Trials are said to have shown that the online system reduces the risk of error during a patient’s handover, when information on medicines and procedures they have undergone is transferred.

Tim Kelsey, NHS England’s national director for patients and information, said: “Every day, care is held up and patients are kept waiting while an army of people transport and store huge quantities of paper round our healthcare system.

“This approach is past its sell-by date. We need to consign to the dustbin of history the industry in referral letters, the outdated use of fax machines and the trolleys groaning with patients’ notes.”