Personal Health Budgets: Process and context following the national pilot programme: Working Paper 2947

The general approach of the current report – in line with process evaluation methods (Moore et al., 2015) – was to learn from (a) the experience of organisational representatives with responsibility for personal health budget policy and practice; and (b) budget holders since the national pilot programme and also (by way of some contrast) from the experiences of new budget holders. In particular, we sought to infer key mechanisms of effect, and reflect on the contexts in which they operated (Pawson and Tilly, 2007). Together, mechanisms and context help us understand why we saw the outcomes of personal health budgets that were found in the national evaluation, and conjecture on how changing context – specifically, post-pilot operation of the policy – might have an impact.

Based on the studies to date, the following process factors were expected to be important in determining the success of personal health budgets:

* Different budget-setting process

* Support planning and review process

* The development of the range of services available and availability of providers

* The extent of integration between health and social care

We explored these issues using a process evaluation approach that involved interviews with both organisational representatives – i.e. people charged with implementing personal health budgets – and with budget holders. Semi-structured interviews were conducted, with topics framed around the hypothesised process factors. Audio-files of the interviews were transcribed verbatim and were analysed using software NVivo 10 for Windows (QSR International Pty Ltd).