Health and social care systems support

PersonalHealth Budgets

PersonalHealth Budgets

Effective delivery of Personal Health Budgets (PHBs) is crucial for Clinical Commissioning Groups (CCGs) to achieve the ambitious expansion targets set out in the Five Year Forward View.

The NHS mandate sets a goal of achieving 50,000-100,000 PHBs by 2020, with CCGs expected to deliver personal budgets for between 0.1% and 0.2% of their population. The NHS mandate sets a goal of achieving 50,000-100,000 PHBs by 2020, with CCGs expected to deliver personal budgets for between 0.1% and 0.2% of their population. Due to the scale of the task, most CCGs are still in the early stages of formulating their solution for effective delivery of PHBs, with even the initial pilot sites only delivering services for a small cohort of budget holders.

Arden & GEM delivers a flexible PHB service designed to meet your exact requirements, from full end-to-end support to modular provision which dovetails with your existing in-house resource.

We currently supply PHB support spanning five counties and 12 Clinical Commissioning Groups, and have a unique operating model that allows you to upscale at pace. We have the experience, processes and capacity to enable the effective delivery of PHBs for your local population.

Our PHB serviceOur PHB service provides support for Clinical Commissioning Groups in three areas:

PHB Diagnostics

PHB Service Delivery

Specialist PHB Training

All reviews provide detailed recommendations and action plans including realistic timeframes for implementation.

We have designed a four stage PHB ‘readiness review’ model which spans strategy, operational delivery, facilitation and PHB in practice. Typical areas of review include:

• PHB policy to ensure compliance with the national mandate.

• Internal processes across referrals, assessment and decision making.

• Joint working and shared understanding and goals that includes stakeholder mapping to establish the wider cohorts (social care, mental health trusts and community staff etc.).

• Financial pathways incorporating payment mechanisms, managed accounts and direct payments.

• Contracts and procurement to maximise efficiency for PHBs and suppliers.

• PHB budget setting process and procedures that ensure both efficiency and equality.

• Risk and quality assurance to keep patients safe and deliver the best health and wellbeing outcomes.

• Workforce planning that audits existing clinical, financial and administrative resources to allow planning around future capacity issues.

• Skills audits to assess capabilities and identify gaps to drive training plans.

We have the experience, processes and capacity to enable the effective delivery of PHBs for your local

population.

PHB diagnosticsWhether you require a full operational review or scrutiny of an isolated area of concern, our diagnostic service can help. Our experienced team can conduct a full review of your current PHB systems and process against national requirements and produce a thorough gap analysis.

PHB service delivery

Regardless of where you are in formulating your solution, we can assist you in the delivery of an effective PHB service for your population.

Arden & GEM is able to host your entire end-to-end PHB service with local variations that meet your exact needs.

Our established single operating model ensures full compliance with the NHS England mandate, empowers patients and delivers at scale efficiencies.

Working with Arden & GEM provides access to our fully ratified PHB processes, templates, toolkit and training.

Our clinically-led service uses a unique seven-step model to create and manage PHBs and has been developed using both national guidance and learning from early adopter sites.

Understand the person’s health and wellbeing needs and identified

risks

Making a care

plan, identifying the risks and contingencies

Organising careand support

Monitoring and review

Consent is obtained

Making contact and getting clear

information

Working out

the amount

of money available

We work collaboratively with patients to create effective care plans, source providers and ensure all PHBs are fully ratified by the CCG.

PHB service delivery

PHB strategy and policy developmentCreating and embedding an effective strategy for your PHB service is a complex task. Our team has developed a deep understanding of how PHBs work through experience and learning and access to best practice gained across multiple geographies. Our support includes:

• PHB policy and process implementation that utilises our in-depth knowledge of the national mandate.

• Practical workforce planning drawing on our experience of PHB service delivery.

• Financial modelling that allows you to effectively forecast and plan for the ongoing needs of your population.

We will support you during every stage in development of your PHB service - throughout strategy, delivery and review

PHB assessment and back office supportArden & GEM manage the day-to-day clinical and operational PHB delivery for a large number of CCGs.

Employing over 150 clinical staff, we have the nursing expertise and capacity required to meet the needs of your population. All of our assessors are fully qualified and trained to industry leading standards that ensure the delivery of efficient and effective care. We work collaboratively with patients to create effective care plans, source providers and ensure all PHBs are fully ratified by the CCG.

Our extensive PHB operation delivers administrative hubs that provide at-scale, cost effective back office support including: receipt of referral, processing referrals, scheduling of nurse visits (including reviews), patient communications, data reporting, care provider brokerage, provider procurement/market management, contract management, quality management, invoice processing, submitting benchmarking data, out of area work and policy development (provision and application).

Specialist PHB training

Personal Health Budgets are complex and challenging to deliver. Even generously resourced operations may not have all of the experience and knowledge required to ensure an effective service.

The skill mix of your workforce must continually adapt to meet the challenges created by an evolving PHB agenda.

Drawing on our detailed knowledge of PHB delivery, we provide market leading training that delivers both insight and knowledge transfer. Our experts provide training in three areas:

• Planning for PHBs - Providing the skills, processes and templates required for effective PHB planning (including access to our unique PHB toolkit).

• Philosophy of PHBs - ensuring your organisation embeds the philosophy of PHBs required to successfully deliver against the NHS England mandate.

• Bespoke training - developed in collaboration with you to address specific skills gaps in your current operation or workforce.

Our PHB case management services provide invaluable support to both commissioners and budget holders. We offer:

• Full management of PHB reviews to ensure care continues to meet the needs of patients and is delivered in the most efficient way.

• Strict governance to ensure money is spent appropriately.

• Accurate and efficient finance services (including management of direct payments).

• Brokerage services developed in partnership with the third sector to support service users.

• Access to our E-marketplace that allows patients to select services and manage their budget.

Ongoing PHB case management

The benefits• Cost effective solutions that share the financial benefits delivered by our operating model and scale.

• Peace of mind that your PHB service is completely compliant with the NHS England mandate and incorporates robust governance and decision making.

• Flexible services and mobile resources that can be shaped to meet your evolving needs.

• Reassurance that patients are simultaneously receiving cost effective PHBs and truly patient centred care.

• Access to our operation-wide steering group that nurtures best practice and delivers continuous improvement.

Why Arden & GEM?In one geographical area our PHB service has already delivered a tangible 16% cost avoidance compared to traditionally commissioned care packages. This has allowed the CCG to reinvest this saving back into their service.

Working collaboratively with a large number of CCGs to develop their PHB offer has delivered invaluable experience and learning. We reflect what works well from our local experience as well as integrating national best practice into the service provided.

With over 1,000 members of staff spanning multiple geographies, our services offer visible, embedded support and flexible capacity to meet your needs. Our fully trained, qualified and registered PHB team brings unrivalled knowledge and experience gained from across the personalisation agenda.

We are committed to being at the cutting edge of PHB delivery to enable continuous improvement. For example: connecting clinicians and patients with new technology, developing an e-marketplace to assist in the selection of services, and working with pilot sites to supportthe move towards Integrated Personal Commissioning (IPC).

We also actively contribute to NHS England policy and guidance and are involved in ongoing projects and training around the development of PHBs nationally.

Whatever stage you are at in developing your PHB solution, we would welcome the opportunity to support you.

In one geographical area our PHB service has already delivered a tangible 16% cost avoidance compared to traditionally commissioned care packages.

Specialist PHB training

Health and social care systems support

For details about our full range of services, please contact us:

website: www.ardengemcsu.nhs.uktwitter: @ardengememail: contactus@ardengemcsu.nhs.uk

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