Personalisation: Personal budgets and care services in Portsmouth

Healthwatch Portsmouth carried out research with around 230 people, including care recipients, carers and people who may need care in the future, to explore experiences of personal budgets and person-centred care. The study found that personal budget holders generally reported more positive experiences of care than non-budget holders, particularly in relation to communication, involvement in planning and having greater control over services. However, many respondents felt that obtaining and managing a personal budget was overly complicated, involving significant paperwork, confusing processes and concerns about payment systems. 

Experiences of care services were mixed. Around 58% of respondents felt their care was person-centred most or all of the time, but many reported problems with communication, care coordination and involvement in decision-making. Common concerns included inconsistent staffing, poor communication between organisations, carers arriving late or not as expected, and services not always adapting to individual routines, preferences or circumstances. 

People not currently receiving care had very high expectations of future services, with around 86% expecting key aspects of person-centred care to be delivered most or all of the time. This was significantly higher than the experiences reported by current care recipients, highlighting a gap between expectations and reality. Respondents consistently said they wanted care that respected their preferences, involved family members where appropriate, provided clear information, and was designed around their lives rather than provider convenience.

Healthwatch concluded that while personal budgets can improve choice and control, both personal budget arrangements and care services could be made more person-centred. Recommendations included improving information and awareness about personal budgets, reducing bureaucracy, strengthening communication and coordination between services, improving staff training in areas such as dementia and autism, supporting people through transitions into adult services, and involving care recipients more closely in the design and review of services.