FOI request reveals NHS personal health budget spends include holidays, horse riding lessons and vacuum cleaners

Holidays

Thousands of pounds of NHS money has been spent on an eclectic and seemingly bizarre list of purchases including holidays, games consoles, household appliances, a summer house and singing lessons, an investigation by GP magazine Pulse has found.

According to information obtained via a request made by the magazine under the Freedom of Information Act (FOI), in some regions thousands of pounds of NHS money has been spent on what many would deem to be luxury, non-essential items and services.

The personal health budget scheme was introduced in October last year, with eligible patients suffering from long-term health conditions given the freedom to decide how to spend NHS cash to improve their own health outcomes, subject to clinical agreement from a GP or NHS health care team.

The pilot scheme had previously faced criticism when it was found that some patients were using the funds to buy frozen ready meals and theatre tickets.

Horse Riding

While many patients use their budget to pay for a personal assistant to help with everyday tasks such as washing and dressing, therapy, mobility equipment and other care provision - costs which would otherwise sometimes be met by separate funding - some have, according to figures, opted to spend the money on non-traditional items and services, including aromatherapy, horse riding lessons and in one case, a pedalo ride.

Quality of life

A spokesman for the Department of Health told Pulse: "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. They are cost-neutral and so do not take anything away from the public purse."

An independent evaluation, undertaken into the pilot scheme by the Personal Social Services Research Unit at the University of Kent identified a "significant improvement in the quality of life and psychological wellbeing of the patients and a reduction in hospital costs", although it was noted that patients frequently used the money to access non-NHS services to meet their individual requirements.

"Inappropriate use of scarce NHS money"

Senior doctors have expressed concerns over the scheme which is enabling some patients to treat themselves to luxurious items whilst many sectors within the NHS are subject to cuts, with the prospect of funding for vital services being trimmed elsewhere in order for clinical commissioning groups (CCGs) to continue delivering the personal health budget scheme.

Dr Richard Vautrey, deputy chairman of the British Medical Association's General Practitioners Committee, says: "We continue to have real reservations about this scheme and the inappropriate use of scarce NHS money on non-evidence-based therapies.

"While individuals may themselves value a massage or summer house, others will understandably start to question why they can't also have such things paid for by the state – and that will just fuel demand."

Penny pinching

Dr Vautrey said CCGs were always looking to "penny-pinch" in order to maintain current NHS services and a small cut to funding could jeopardise a whole service. He adds: "This can have serious implications for large numbers of people just based on the whims of a small number."

Coins

The information obtained by Pulse appears to indicate an at times vast regional variation in spending per patient, with three CCGs across West Sussex reporting a combined cost of £2.6 million in 2014-15 across just 44 patients.

In Northamptonshire, £2.55 million was spent on personal health budgets for 161 patients, with reported purchases including a satellite navigation system and a summer house.

In Cornwall, a reported £267,000 was spent on five patients, including £2,080 on aromatherapy treatments and a Stoke on Trent CCG spent £114,000 across 115 patients on items including a Wii Fit games bundle and music lessons.

Editor of Pulse, Nigel Praities, told the BBC that readers had responded to the story with "dismay", adding: "Doctors have to follow the evidence, they have to make sure everything they do is effective. To see in other areas of the NHS money maybe being spent on things that doesn't have such evidence behind it, particularly at a time when the NHS is trying to save lots of money, is hard to swallow."

The projected budget for 2015-16 for the 33 CCGs that responded to the request revealed an estimated average of £589,000 each that, if applied to all 209 CCGs, would total a £123 million spend on personal health budgets to meet the needs of 4,800 patients.

Despite its 2014 commitment to deliver £22 billion in efficiency savings by 2020, without impacting on current service levels, NHS England's Five Year Forward View has called for a " major expansion" of the personal health budget scheme.


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