Personal Health Budgets for renal patient transport

Barnsley renal unit have been running a Personal Health Budget (PHB) pilot for renal patient transport over the past year. The Barnsley team encountered quite a few barriers to establishing this pilot including having to separate out the financial element of the renal transport contract from the block contract which NHS Barnsley holds with the Yorkshire Ambulance Service.

The following typical day for one of the patients enrolled in the pilot provides some insight into the benefits that can be realised.

PTS do not give the patient a ‘pick up’ time, they are told to be ready a few hours prior to their appointment, which for Patient X, who has to be on the unit by 7.30am to start treatment at 8am, may be from 5am onwards. Patient X’s treatment finishes at 11.45am, however, he has to wait for two other patient’s whose treatment may finish one hour after his, before they are driven home and he is then the last person to be dropped off at home, which means that he arrives home, at times two hours after he has finished his treatment, which equates to a nine hour session, from waiting to be picked up, to being dropped off back at home.

Having the PHB will allow Patient X to be picked up at a set time, arriving at the unit 30 minutes prior to his appointment, arriving home 30 minutes after he finishes his treatment and reducing his day from nine hours to five and a half hours. Taking into account that this happens three times per week, this means that Patient X will have an extra ten and a half hours to himself per week, which is a large proportion of his life.

Patient X is very optimistic about having a PHB and is absolutely certain that it will bring about a massive improvement upon his quality of life.

If that’s not enough stimulus to consider PHBs or other solutions to the delays many patients experience, there is a significant financial saving to be made of around £2500 per annum for each patient who opts for a PHB rather than the standard patient transport service.

Given the benefits I am intrigued that only 3 of the potential 64 patients have signed up for the PHB pilot and wonder why that is. The interim analysis does however seem to provide proof of concept that PHBs can work for patients receiving in-centre and satellite haemodialysis, that they can improve experience and quality of care and that they can save money.