pulseWith thanks to Pulse 30.10.09:

Patients will be able to spend NHS money on treatments like homeopathy and acupuncture as part of the controversial personal health budget scheme, according to new details released by the Department of Health.

Other ‘non-traditional’ services patients can choose from include personal assistants, equipment, complementary therapies or transport.

NICE guidance will ‘still apply where relevant’ but only alcohol, tobacco, gambling, debt repayment and GP/emergency services are specifically excluded from direct budgets in the guidance.

The document says everyone ‘capable of managing a direct payment’ will be given one as part of the pilots of personal health budgets announced in 20 PCTs last month.

The pilots are expected to involve thousands of GPs, who will help patients draw up a care plan, allocate the money they are given and review the plan regularly.

‘They could be spent on any services, as long as they are legal and appropriate for Government to fund,’ says the document.

The plans for direct payments have been slammed by the GPC. Negotiator Dr Chaand Nagpaul, a GP in Edgware, Middlesex, said the proposals were a distraction for GPs already working at full capacity.

‘This is adding unnecessary additional bureaucracy at a time when the NHS is going to have to make savage cuts. There seems to be nothing that cannot be achieved through effective practice-based commissioning,’ he said.

He added: ‘I think there seems to be some confusion in Government policy. On the one hand they have been quite clear that the NHS should use resources based on evidence-based guidance developed by NICE, but there seems to be some confusion about the degree of flexibility patients will have. For example most complementary therapies are not supported by NICE guidance’

Dr Michael Dixon, NHS Alliance chair and a GP in Cullompton, Devon, is a vocal supporter for the integration of complementary medicine into the NHS.

He said he supported bringing commissioning closer to the patient, but the project would ‘wither on the vine’ unless it could show patients could keep to budget.

‘Patients with budgets will be allowed to go outside NICE guidelines, but need to pay for reasonable things provided they are within budget.’

‘One major issue will be to see if they are good at keeping to budget and possibly save money in a cold financial climate. If they are not they will wither on the vine,’ he said.

How direct payments could be used

- Course of physiotherapy or hydrotherapy for chronic pain
- Air conditioner for someone suffering respiratory conditions
- Personal assistant to provide care
- Complementary therapies e.g. acupuncture, homeopathy
- Transport to attend treatment
- Respite care

Source: Direct payments for healthcare, Department of Health, October 2009