Supporting finance to enable personalised care

by Sue Bottomley

12 August 2019

It’s unusual as an NHS England finance lead to be excited about launching a comprehensive new handbook. And I don’t expect you to be excited at the prospect of accessing it. But this one is different.

It’s designed to help you implement personalised care – all six components – across clinical commissioning group, sustainability and transformation partnership and regional footprints. It makes finance an enabler, not a blocker. And it gives you tips and tricks from my team’s many years of experience that will help you squeeze more from your budgets.

There are 10 top tips that can transform the commissioning landscape for you locally. The most important in my view is the first one – 100% of contracts and specifications should reflect personalised care.

Personalised care is going to be huge for us all working in the NHS over the next years. However, as with most culture changes, small steps are key to introducing change successfully. My strongest tip would be to have this as your mantra for the next year.

10 key finance, commissioning and contracting actions






100% of contracts and specifications should reflect personalised care

2 and 4


Commissioners need to reduce any local barriers to implement shared decision making for those who would benefit and embed shared decision making in contract monitoring



Commissioners need to reduce any local barriers to implement personalised care and support plans and consider workforce training requirements to ensure all those who would benefit from a personalised care and support plan will be facilitated by a skilled workforce



100% of contracts should describe how choice and flexible approaches are reflected



Commissioners need to consider outputs from social prescribing beyond the NHS and work with local partners to extend the offer across the voluntary and community sector



Commissioners need to work with providers to ensure people are supported to self-care and that individual assets are developed to self-manage healthcare



Commissioners should work with partners to ensure that contracts and service specifications reflect the requirement to offer and expand personal health budgets for those who would benefit; to be supported by financial systems for the transactional requirements



Commissioners should consider use of local incentive schemes to increase the opportunity for personalised care



Commissioners will develop local data systems and embed contract monitoring for measuring successful input of personalised care



Commissioners should explore opportunities for lead commissioner function managing Integrated Care Provider contracts where economies of scale are useful



Get personalised care onto agendas, make everyone take notice of your intentions, and build this new model together in partnership. Small steps now will be the making of your long-term plans.

I’d also concentrate my early efforts on building blocks. Personal health budgets are high profile, but shared decision-making and personalised care and support plans are the backbone of personalised care. How can we possibly make care more personalised without having conversations with people and then recording plans to make that happen? Check out the handbook for practical advice and guidance.

I really can’t think of any long-term condition (LTC) cohort that wouldn’t benefit from this approach, although it has to be done well. So, support your providers in getting people trained and make sure they understand how and where they can be useful.

Further actions focus on working with others and harnessing skills and resources outside the traditional model. Many health professionals may struggle with this concept to start with, but flexible approaches to ensuring people get what is right for them is the future.

We need to take people along with us and allow them to take more responsibility for their own health.

As a commissioner in a previous life, I understand that this type of change is daunting. How do we release the money and get those less traditional ways of working into our rigid contract processes?

Perhaps the most significant shift over the past 70 years has been the increase in LTCs. Seven in every 10 hospital beds are occupied by someone with an LTC, and 70p in every NHS pound is spent on supporting LTCs. By 2035, two-thirds of adults are expected to be living with multiple health conditions and 17% will have four or more conditions. This all leads to further financial pressure. That’s why I am so keen to ensure finance and contracting commissioners get the support they need to make these ambitions a reality.

Although the handbook is full of useful information, we couldn’t squeeze it all in. Therefore, we have additional documents and guides available for healthcare professionals on the personalised care collaborative network. Have a look at these and join our community.

As we are all aware, these are new and exciting times for the NHS. Our ambition is to keep up with new approaches for contracting for personalised care and we will endeavour to share as much as we can this coming year on the collaborative network.

To access the new personalised care collaborative network contact NHS England.

and follow on twitter @Pers_Care)