Musekiwa, Editor (2022). Are personal health budgets delivering choice and control for people with complex healthcare needs? An ethnographic case study. University of Birmingham. Ph.D.
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Musekiwa2022PhD.pdf
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Abstract
Abstract
Background: This doctoral thesis explores Personal Health Budgets (PHBs) in the English National Health Service, a new and evolving policy initiative and part of the wider personalisation agenda. As a policy direction, the personalisation of services in health and social care continues to be surrounded by debate and controversy. This thesis, therefore, seeks to advance our understanding of the opportunities and challenges of the practice of choice and control within personal health budgets, through the eyes of budget holders.
Methods: The research was carried out in England over a 2-year period (January 2018 – January 2020). The study used ethnographic case studies combined with realist evaluation to identify and examine the broad evidence alongside a realist interrogation to evaluate programme theories of how PHBs are supposed to work in practice. Three participants from different geographic locations and Clinical Commissioning Groups (CCGs) took part. Taking a longitudinal approach, the study sought to answer the question: “Are personal health budgets delivering choice and control for people with complex healthcare needs?” The research was done in a natural setting and provided a unique opportunity to explore the relationships between choice and control as a dynamic process over time.
Findings: PHBs can deliver choice and control for people with complex healthcare needs if: there is sufficient access to resources, if decision-making is shared, and if professionals are willing to accept the knowledge claims of PHB holders. Time is an important factor: the experiences of budget holders improved with time as personal health budgets become more embedded in practice.
Limitations: This study only focused on three PHB holders in England, so the scope is limited. However, there are important lessons that can be drawn from the findings to shape future policy and practice within the wider context.
| Type of Work: | Thesis (Doctorates > Ph.D.) | |||||||||
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| Award Type: | Doctorates > Ph.D. | |||||||||
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| Licence: | All rights reserved | |||||||||
| College/Faculty: | Colleges (2008 onwards) > College of Social Sciences | |||||||||
| School or Department: | School of Social Policy | |||||||||
| Funders: | None/not applicable | |||||||||
| Other Funders: | Self funded | |||||||||
| Subjects: | H Social Sciences > H Social Sciences (General) | |||||||||
| URI: | http://etheses.bham.ac.uk/id/eprint/12361 |
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