Skip to main content
SpringerLink
Log in

Co-commissioning at the Micro-Level: Personalised Budgets in Health and Social Care

  • Chapter
  • First Online:
The Palgrave Handbook of Co-Production of Public Services and Outcomes

  • 2401 Accesses

Abstract

This chapter discusses co-commissioning of health and social care services at the micro-level, in which individuals are active participants in the planning and purchasing of their care and support. The chapter presents empirical data on co-commissioning in the English NHS, with a particular focus on personalised budgets. An ethnographic case study was undertaken with people who have chronic conditions who are accessing personal health budgets. The ethnographic nature of the study allowed the co-commissioning process to be studied in depth and over time. The data highlights the extent to which co-commissioning is an iterative learning process, in which relationships and power dynamics shift. The findings re-affirm the broader insights into co-production as an activity imbued with power asymmetries and ambiguity about who is the ‘expert’.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 249.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Alakeson, V. (2010). International development in self-directed care. Issue Brief (Commonwealth Fund), 78, 1–11.

    Google Scholar 

  • Alakeson, V. (2013). The individual as service integrator: Experience from the personal health budget pilot in the English NHS. Journal of Integrated Care, 21(4), 188–197.

    Article  Google Scholar 

  • Barnes, C. (2007). Disability activism and the struggle for change: Disability, policy and politics in the UK. Education, Citizenship and Social Justice, 2(3), 203–221.

    Article  Google Scholar 

  • Baxter, K., Glendinning, C., and Clarke, S. (2008). Making informed choices in social care: The importance of accessible information. Health and Social Care in the Community, 16(2), 197–207.

    Article  Google Scholar 

  • Bovaird, T., and Loeffler, E. (2013). We’re all in this together: Harnessing user and community co-production of public outcomes. Birmingham: Institute of Local Government Studies: University of Birmingham, 1, 15.

    Google Scholar 

  • Care Act. (2014). London: The Stationery Office. http://www.legislation.gov.uk/ukpga/2014/23/pdfs/ukpga_20140023_en.pdf. Accessed 15 September 2019.

  • Coulter, A., Entwistle, V.A., Eccles, A., Ryan, S., Shepperd, S., and Perera, R. (2015). Personalised care planning for adults with chronic or long‐term health conditions (3). Cochrane database of Systematic Reviews (3).

    Google Scholar 

  • Da Roit, B., and Le Bihan, B. (2010). Similar and yet so different: Cash‐for‐care in six European countries’ long‐term care policies. The Milbank Quarterly, 88(3), 286–309.

    Article  Google Scholar 

  • Darzi, A. Lord (2008). High quality care for all: NHS next stage review: Final report. London: Department of Health.

    Google Scholar 

  • Department of Health. (2007). Putting people first: A shared vision and commitment to the transformation of adult social care services. London: Department of Health.

    Google Scholar 

  • Department of Health. (2009). Personal health budgets: First steps. London: Department of Health.

    Google Scholar 

  • Department of Health and Social Care. (2019). https://www.gov.uk/government/news/expansion-of-budgets-for-personalised-health-and-care-support-announced. Accessed 15 September 2019.

  • Durose, C., Needham, C., Mangan, C., and Rees, J. (2017). Generating ‘good enough’ evidence for co-production. Evidence & Policy: A Journal of Research, Debateand Practice, 13(1), 135–151.

    Google Scholar 

  • Eikelenboom, N., van Lieshout, J., Jacobs, A., Verhulst, F., Lacroix, J., van Halteren, A., Klomp, M., Smeele, I., and Wensing, M. (2016). Effectiveness of personalised support for self-management in primary care: A cluster randomised controlled trial. British Journal of General Practice, 66(646), e354–e361.

    Article  Google Scholar 

  • Forder, J., Jones, K., Glendinning, C., Caiels, J., Welch, E., Baxter, K., Davidson, J., Windle, K., Irvine, A., King, D., and Dolan, P. (2012). Evaluation of the personal health budget pilot programme.

    Google Scholar 

  • Gadsby, E.W. (2013). Personal budgets and health: A review of the evidence. Centre for Health Services Studies. Kent: University of Kent.

    Google Scholar 

  • Glasby, J., and Dickinson, H. eds. (2009). International perspectives on health and social care: Partnership working in action. Chichester: Wiley.

    Google Scholar 

  • Glasby, J., and Littlechild, R. eds. (2016). Direct payments and personal budgets: Putting personalisation into practice. Bristol: Policy Press.

    Google Scholar 

  • Glendinning, C. (2008). Increasing choice and control for older and disabled people: a critical review of new developments in England. Social Policy and Administration, 42(5): 451–469.

    Google Scholar 

  • Greener, I. (2003). Who choosing what? The evolution of the use of ‘choice’ in the NHS, and its importance for New Labour. Social Policy Review, 15, 49–68.

    Google Scholar 

  • Grit, K., and de Bont, A. (2010). Tailor-made finance versus tailor-made care: Can the state strengthen consumer choice in healthcare by reforming the financial structure of long-term care? Journal of Medical Ethics, 36(2), 79–83.

    Article  Google Scholar 

  • Health Foundation. (2010). Personal health budgets. Research scan: Health Foundation.

    Google Scholar 

  • Henwood, M., McKay, S., Needham, C. and Glasby, J. (2018). From bystanders to core participants? A literature and data review of self-funders in social caremarkets [Online]. Available at: https://www.birmingham.ac.uk/Documents/college-social-sciences/social policy/HSMC/publications/2018/UoB-PRP-Self-funders-review-of-data-and-literature-FINAL.pdf. Accessed 2 September 2019.

  • Hyde, P., and Davies, H.T. (2004). Service design, culture and performance: Collusion and co-production in health care. Human Relations, 57(11), 1407–1426.

    Article  Google Scholar 

  • In Control. (2015). Promoting people’s right to choice and control under the Care Act 2014: How are local authorities performing? In Control.

    Google Scholar 

  • In Control. (2017a). Payment cards in adult social care: A national overview 2017. Shaw Trust on behalf of the Independent Living Strategy Group [Online]. Available at: http://www.in-control.org.uk/media/247072/payment%20cards%20in%20adult%20social%20care.pdf. Accessed 15 September 2019.

  • In Control. (2017b). The personal health budget holders and family carers. POET Surveys.

    Google Scholar 

  • Independent Living Strategy Group. (2017). Payment Cards in Adult Social Care: A National Overview Report: Independent Living Strategy Group.

    Google Scholar 

  • Institute of Fiscal Studies. (2018). Changes in Councils’ adult social care and overall service spending in England, 2009–2017–18. Briefing: Institute of Fiscal Studies.

    Google Scholar 

  • Izuhara, M. (2003). Social inequality under a new social contract: Long‐term care in Japan. Social Policy & Administration, 37(4), 395–410.

    Article  Google Scholar 

  • Jones, K., Caiels, J., Forder, J., Welch, E., and Fox, D. (2017). Personal health budgets: Process and context following the national pilot programme. Working Paper 2947. Canterbury: Personal Social Services Research Unit, University of Kent.

    Google Scholar 

  • Jones, K., Caiels, J., Forder, J., Welch, E., and Fox, D. (2018). Personal health budgets: Targeting of support and the service provider landscape. Working Paper 2948. Canterbury: Personal Social Services Research Unit, University of Kent.

    Google Scholar 

  • King’s Fund, and Nuffield Trust. (2016). Social care for older people. Available at:https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Social_care_older_people_Kings_Fund_Sep_2016.pdf. Accessed 15 November 2017.

  • Kirkegaard, S., and Andersen, D. (2018). Co-production in community mental health services: Blurred boundaries or a game of pretend? Sociology of Health andIllness, 40(5), 828–842

    Google Scholar 

  • Kretzmann, J., and McKnight, J. (1993). Building communities from the inside out: A path towards finding and mobilising a community’s assets. Evanston, IL: Institute for Policy Research.

    Google Scholar 

  • Mansell, J., and Beadle-Brown, J. (2004). PCP or Person-Centred Action? Policy and practice in intellectual disability services. Journal of Applied Research in Intellectual Disabilities, 17, 1–9.

    Article  Google Scholar 

  • Marks, L., Cave, S., and Hunter, D.J. (2010). Public health governance: Views of key stakeholders. Public Health, 124(1), 55–59.

    Article  Google Scholar 

  • McMullin, C., and Needham, C. (2018). Co-production in healthcare. In Brandsen, T., Steen, T., & Verschuere, B. (Eds.), Co-production and co-creation: Engaging Citizens in Public Services (pp. 151–160). New York: Routledge.

    Google Scholar 

  • National Audit Office. (2018). Adult social care at a glance. https://www.nao.org.uk/wp-content/uploads/2018/07/Adult-social-care-at-a-glance.pdf. Accessed 15 September 2019.

  • Needham, C. (2009). Interpreting personalization in England’s national health service. Critical Policy Studies, 3(2), 204–220.

    Article  Google Scholar 

  • Needham, C. (2011). Personalising public services: Understanding the personalisation narrative. Bristol: Policy Press.

    Google Scholar 

  • Needham, C., and Glasby, J. eds. (2014). Debates in Personalisation. Bristol: The Policy Press.

    Google Scholar 

  • Newman, J., and Clarke, J. (2009). Publics, politics and power: Remaking the public in public services. London: Sage.

    Google Scholar 

  • NHS England. (2014). Guidance on the “right to have” a personal health budget in adult NHS Continuing Healthcare and children and young people’s Continuing Care. Person Centred Care Team: NHS England.

    Google Scholar 

  • NHS England. (2015). Frequently asked questions: Introducing personal health budgets beyond NHS Continuing Healthcare. Person Centred Care Team: NHS England.

    Google Scholar 

  • NHS England. (2017). Involving people in their own health and care: Statutory guidance for Clinic Commissioning Groups and NHS England [Online]. Available at: www.personalhealthbudgets.england.nhs.uk. Accessed August 2019.

  • Ostrom, E. (1996). Crossing the great divide: Synergy, and development. World Development, 24(6), 1073–1087.

    Google Scholar 

  • Pavolini, E., and Ranci, C. (2008). Restructuring the welfare state: Reforms in long-term care in Western European countries. Journal of European Social Policy, 18(3), 246–259.

    Article  Google Scholar 

  • Price, C. (2015). Revealed: NHS funding splashed on holidays, games consoles and summer houses. Pulse, 1 September. http://www.pulsetoday.co.uk/news/commissioning-news/revealed-nhs-funding-splashedon-holidays-games-consoles-and-summer-houses/20010960.fullarticle. Accessed 12 August 2019.

  • Shakespeare, T., Porter, T., and Stӧckl, A. (2017). Personal assistance relationships: Power, ethics and emotions. Report on ESRC Project ES/L007894/1.

    Google Scholar 

  • Slasberg, C., Beresford, P., and Schofield, P. (2012). How self-directed support is failing to deliver personal budgets and personalisation. Research, Policy and Planning, 29(3), 161–177.

    Google Scholar 

  • Social Care Institute for Excellence in conjunction with Carers UK. (2009). Personalisation briefing: Implications for commissioners. London: SCIE. https://www.scie.org.uk/publications/ataglance/ataglance06.pdf. Accessed 16 January 2020.

  • Timonen, V., Convery, J., and Cahill, S. (2006). Care revolutions in the making? A comparison of cash-for-care programmes in four European countries. Ageing & Society, 26(3), 455–474.

    Article  Google Scholar 

  • Ungerson, C., (2004). Whose empowerment and independence? A cross-national perspective on ‘cash for care’ schemes. Ageing & Society, 24(2), 189–212.

    Article  Google Scholar 

  • Ungerson, C., and Yeandle, S. eds. (2007). Cash for care system in developed welfare states. Basingstoke: Palgrave Macmillan.

    Google Scholar 

  • United Nations. (1994). Convention on the rights of persons with disabilities. New York: United Nations.

    Google Scholar 

  • Van Ginneken, E., Groenewegen, P.P., and McKee, M. (2012). Personal healthcare budgets: What can England learn from the Netherlands? BMJ Clinical Research Edition, 344, e1383.

    Article  Google Scholar 

  • Vennik, F.D., van de Bovenkamp, H.M., Putters, K., and Grit, K.J. (2015). Co-production in healthcare: Rhetoric and practice. International Review of Administrative Sciences, 82(1), 119.

    Google Scholar 

  • Williams, I., Bovaird, T., Brown, H., Allen, K., Dickinson, H., Kennedy, J., and Glasby, J. (2012). Designing whole-systems commissioning: Lessons from the English experience. Journal of Care Services Management, 6(2), 83–92.

    Article  Google Scholar 

  • Yeatman, A., Dowsett, G., Fine, M., and Gursansky, D. (2009). Individualization and the delivery of welfare services: Contestation and complexity. Basingstoke: Palgrave.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Birmingham, Birmingham, UK

    Editor Musekiwa & Catherine Needham

Authors
  1. Editor Musekiwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Catherine Needham
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Catherine Needham .

Editor information

Editors and Affiliations

  1. Strathclyde Business School, University of Strathclyde, Glasgow, UK

    Elke Loeffler

  2. INLOGOV, School of Government, University of Birmingham, Birmingham, UK

    Tony Bovaird

Rights and permissions

Reprints and permissions

Copyright information

© 2021 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Musekiwa, E., Needham, C. (2021). Co-commissioning at the Micro-Level: Personalised Budgets in Health and Social Care. In: Loeffler, E., Bovaird, T. (eds) The Palgrave Handbook of Co-Production of Public Services and Outcomes. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-53705-0_13

Download citation

Publish with us

Policies and ethics

Search

Navigation