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Full or Partial Capability status. For this Capability, Solutions are re= quired to meet a minimum of one MUST EPIC and associated acceptance criteri= a but not all MUST EPICs (where there are multiple MUST EPICS) to achieve P= artial Capability Status, or; to meet all MUST EPICs and their associated a= cceptance criteria to achieve Full Capability Status.
Personal Health Budgets are amounts of money allocated to a Patient/Serv= ice User to support their health and well-being needs and to enable them to= purchase and manage their own treatments, equipment and personal care. Per= sonal Health Budgets are available to Adults receiving NHS Continuing Healt= hcare and children receiving continuing care - for example, people with lon= g-term physical or mental health issues. Requests outside this are consider= ed on a case basis by the Patient/Service User's CCG.
A Personal Health Budget Capability will allow a Personal Health Budget = to be defined, reviewed and updated. The Capability facilitates the li= nk between the Personal Health Budget and the Patient/Service User's care p= lan to ensure spend is directed towards meeting the Patient/Service User's = health goals. A Personal Health Budget Capability will allow purchases of a= range of products and services to deliver the agreed health and well-= being outcomes, for example therapies (e.g. counselling), personal care (e.= g. a personal assistant), services (e.g. gym membership) and equipment (e.g= . a wheelchair). CCGs will be able to assess Personal Health Budgets to ens= ure they are used appropriately.
A Personal Health Budget Capability may manage multiple budgets and the = directory of equipment, treatments and therapies and give further reporting= functionality. It may also link to the Patient record and Workflow tasks t= o further broaden its integration with other functions.
Patient/Service User |
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Care Coordinator or Local NHS Team member or Hea= lth Broker |
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CCG |
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Service Provider |
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As a Patient/Service User
I want to manage my Personal Health Budget
So that I can use my budget to deliver my desired health outco= mes
Given the Health or Care Professional has requested a Personal= Health Budget
When they choose to create the Personal Health Budget
Then the Personal Health Budget is created for the Patient/Service = User
Given the Patient/Service User has been allocated a Personal Health= Budget
When the Patient/Service User chooses an individual to manage = their Personal Health Budget on their behalf
Then the individual can access the Personal Health Budget
And can make purchases on behalf of the Patient/Service User
Given that the Patient/Service User has a Personal Health= Budget
And purchases have been entered
When the Patient/Service User chooses to view the Persona= l Health budget
Then the Personal Health Budget is displayed
Given a Personal Health Budget and care plan has been set up for a = Patient/Service User
When the Personal Health Budget is reviewed
Then a record of the review can be recorded against the Personal He= alth Budget
Given a Personal Health Budget and care plan have been set up for a= Patient/Service User
When the Personal Health Budget is reviewed
Then the Personal Health Budget can be amended
Given a Personal Health Budget and care plan have been set up for a= Patient/Service User
When the Personal Health Budget is reviewed
Then a record of the review can be captured against the Personal He= alth Budget
And the Personal Health Budget can be closed or made inactive
As a Patient/Service User
I want to be able to record Personal Health Budget purchases
So that I can evidence where my Personal Health Budget has been spe= nt
Given that the Patient/Service User can access the Person= al Health Budget Solution
When payment is made for products or services (by the NHS team, a T= hird party or the Patient/Service User)
Then evidence of how and on what the money has been spent (e.g. rec= eipts, invoices, bank statements) can be captured
And this is recorded against the Personal Health Budget for th= e Patient/Service User
As a representative of the CCG
I want to be able to assess Personal Health Budgets
So that I can ensure that Budgets are only spent on appropriate pro= ducts and services
Given the user has been permitted access to the Personal Health Bud= get
And the Personal Health Budget purchase has been recorded
When the user chooses to view the purchase trail against the budget=
Then purchase trail against the budget is displayed
As a Patient/Service User
I want to link my care plan and Personal Health Budget
So that I can ensure that my Personal Health Budget is spent i= n the way most likely to deliver my identified health and well-being outcom= es
Given a care plan has been created for a Patient/Service User
When the Personal Health Budget is created
Then the Budget and care plan for the Patient/Service User can be l= inked
And the care plan can be viewed
Given a Personal Health Budget has been created for a Patient/= Service User
And a care plan has been linked
When items of spend are identified for purchase against the Persona= l Health Budget
Then the purchases can be linked to elements of the care plan
As a Care Coordinator or Local NHS Team
I want to choose a model to manage a particular Personal Health Bud= get
So that I can select the model that will be most appropriate and effecti= ve for the Patient/Service User and their Care Team
Given a Personal Health Budget has been assigned to a Patient/Servi= ce User
When the model to manage Personal Health Budgets is chosen (e.g. vi= a the NHS Care Team, Third Party, direct payment or a combination of these)=
Then different elements of the Budget can be assigned to the releva= nt model
And the agreed equipment, treatments or services can be purchased b= y the relevant individual or Third Party
As a representative of the CCG
I want to apply criteria for the use of Personal Health Budgets
So that I can ensure the Budgets are used only by eligible Patients/Serv= ice Users
Given the Personal Health Budget eligibility criteria has been defi= ned for Patients/Service Users (e.g. Adults eligible for NHS Continuing Hea= lthcare and children receiving continuing care)
When the Patient/Service User is identified as eligible for a Perso= nal Health Budget
Then the Personal Health Budget can be created for the Patient= /Service User
As a Health or Care Professional
I want to make payments relating to Personal Health Budgets
So that I can enable Patient/Service Users to access appropriate pr= oducts and services
Given a Personal Health Budget is being managed with a model (e.g. = via the NHS Care Team, Third Party, direct payment or a combination of thes= e)
When the user chooses to make a payment for a product or service
Then a payment can be made
And the payment can be recorded against the relevant Personal Health Bud= get
As a Personal Health Budget Manager or Health or Care Professional<= /p>
I want to be able to maintain a directory of equipment, treatm= ents or services
So that I can use the directory to find relevant equipment, treatme= nts or services
Given that the user is permitted to create a directory of equipment= , treatments and services in the Personal Health Budget Solution
When the user chooses to create the directory of equipment, tr= eatments and services in the Personal Health Budget Solution
Then the directory is created
Given that the user is permitted to view the directory of equi= pment, treatments and services in the Personal Health Budget Solution
And the directory of equipment, treatments and services has been cr= eated in the Personal Health Budget Solution
When the user chooses to view the directory of equipment, trea= tments and services in the Personal Health Budget Solution
Then the directory is displayed
Given that a directory of equipment, treatments and services has be= en created in the Personal Health Budget Solution
When the user chooses to update the directory of equipment, tr= eatments and services in the Personal Health Budget Solution
Then the directory is amended
Given that a directory of equipment, treatments and services has be= en created in the Personal Health Budget Solution
When the user chooses to remove an item from the directory of equip= ment, treatments and services in the Personal Health Budget Solution
Then then the item in the directory is removed
As a Personal Health Budget Manager or Health or Care Professional<= /p>
I want to be able to search a directory of equipment, treatmen= ts or services
So that I can identify and select the equipment, treatments or services&= nbsp;that will support delivery of the Patient/Service User's healthcare ou= tcomes
Given that a directory of equipment, treatments and services has be= en created in the Personal Health Budget Solution
And search criteria have been defined
When the user chooses to search for equipment, treatment or service= s
Then the list of equipment, treatments or services that match the s= earch criteria are displayed
As a Personal Health Budget Manager
I want to manage budgets from multiple sources (e.g. those relating= to health, care, education or other needs) as a single, joint budget
So that I can more easily manage and co-ordinate across all my need= s
Given a Personal Health Budget has been set up for a Patient/S= ervice User
And the Patient/Service User holds further budgets (e.g. a social c= are Personal Budget) relating to their needs
When the Patient/Service User identifies they want to manage these = as a joint budget
Then the multiple budgets can be managed as a single budget wi= thin the Personal Health Budget tool or system
And the Patient/Service User can use the single, joint budget to pay for= agreed equipment, treatments or services across their health, care, e= ducation or other needs
As a Health or Care Professional
I want to be able to access the Patient Record for the Patient
So that I can confirm their medical history and understand their en= titlement to a Personal Health Budget
Given the Health or Care Professional has been permitted access to = the Patient Record
When the user chooses to view the Patient Record
Then the Patient Record is displayed
As a Health or Care Professional
I want to be able to create a workflow task from the Personal Healt= h Budget Solution
So that I can send requests for information into the Patient/Servic= e User's Practice (e.g. request for clinical information, request for confi= rmation of medical history)
Given the Health or Care Professional has been permitted to create = Workflow Tasks
When the user chooses to create a Workflow task
Then the Workflow task is created
And the task is directed into the workflow for the Practice
As a Service or Product Provider
I want to be able to view the purchases of my products or services<= /p>
So that I can analyse and understand take-up of my products and services=
Given a Provider's products or services are included in the Directo= ry
And they are permitted to view information in the Personal Health B= udget Solution
When they choose to view purchases of their products and services= p>
Then purchase information relating to their products or services is= displayed
As a representative of the CCG
I want to analyse and report against data relating to Personal Health Bu= dgets
So that I can use the results to plan and commission healthcare mor= e effectively to meet the needs of Patients/Service Users
Given the user is permitted to run Management Information repo= rts
When the user chooses to run a Management Information report
Then the Management Information report is displayed
As a representative of the CCG
I want to identify potential candidates eligible for Personal Healt= h Budgets
So that Patients/Service Users can be proactively identified
Given the CCG has defined criteria for prioritising Patient/Service= User need
When the CCG representative inputs the criteria to identify Persona= l Health Budget candidates
Then the results for Patients/Service Users meeting the criter= ia are displayed
Suppliers will have to attain compliance with these Standards = during the compliance stage before they can be live on a framework with thi= s Capability:
None
Suppliers will al= so have to attain compliance with these additional Standards = ;during the compliance stage before they can be live on a framework with th= is Capability:
Suppliers will not be assessed or assured on these Roadmap Items as part= of Onboarding
Roadmap Item | Standards and Capabilities | Status | Effective Date | Description | Change Type | Change Route |
---|---|---|---|---|---|---|
GEN2 Uplifts to Personal Health Budge= t Capability and inclusion of additional MAY Epic |
Published |
Uplifts made to the Personal Heal= th Budget Capability to support the GEN2 Strategy and increase the scope of= the Capability with an additional MAY requirement |
Uplift |
Managed Capacity - Minor/Patch up= lifts |