As We Predicted – Health Personalisation Spending Hits the Headlines!

We always try to bring you the latest news, but (unlike many websites) also where possible add our opinion and experience in order to suggest future directions, rather than simply report the past. So almost five years ago (five years!), on November 18th 2010, we wrote an article titledSocial care procurement – why might personalisation save money?”

It was all about what was then a fairly new idea in the health and social care field, and a conference presentation given by Wynn Spencer of East Cheshire Council. Here is an extract from our article.

“In East Cheshire, as in other councils, social care recipients receive money (in cash or card format) to spend as they wish – within reason – in order to receive the care they need rather than getting the services determined and provided by the council”.

We highlighted some of the issues, and some benefits, for instance this example.

“Care recipients may find more innovative ways of getting what they need; Spencer quoted an elderly Asian lady, whose English was poor, and who paid a fee to her local Indian restaurant for delivery of a meal a day to her home (the council doesn't pay for the actual food, we should note). This was more to her taste, allowed her to have a pleasant daily chat to someone who spoke her language (and could pick up any problems she might be having), and cost the council a third of the previous cost of sending staff or 'usual' suppliers in to cook for her”.

However, we added this warning to our generally positive report on the concept.

“Now that's not to say that there won't be some problems as this develops. You can envisage the potential for “shocked” Daily Mail headlines as recipients come up with different ways of spending 'their' money”. 

Well, it has taken almost five years, but our prediction has come to pass. Yesterday saw a lead article in the Daily Mirror, a Times front page, BBC reports, all based on an article in Pulse, the GP magazine, that was titled “Revealed: NHS funding splashed on holidays, games consoles and summer houses”. It found patients “had used the scheme to buy a sat-nav system, a tablet computer, massage, summer houses and Wii games consoles”.

Now the problem is, without looking at each case in detail, it is impossible to say whether these purchases might have had some medical or care related benefits. Just think of how our curry example above, which seems a thoroughly good idea, could be reported negatively – “Get Your Take-away On The NHS!”.

There is also some argument about whether the scheme actually works for patients. An analysis of a pilot scheme in 2012 concluded that patients received better outcomes than those with more conventionally allocated care, but Nick Watson, a professor of disability research at the University of Glasgow disputed the results.

He suggests patients do not always know best how to use money to help their own health. He is not disputing the concept that people should be involved in decisions, but that “there has to be an evidence base that it would work”. It seems hard to argue with that either.

This is clearly not the end of the debate, and there are also issues around what useful role procurement can play in all of this. We’ve seen interesting developments around marketplaces that individuals can access to buy services, for instance, with procurement playing a leading role in developing this type of solution. But it would be good to think that the debate on personalisation will be logical and evidence based, not full of emotional headlines about “holidays on the NHS”. Well, we can only live in hope!

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