Putting Patients In Control: The case for extending self-direction into the NHS

Engaging patients in their own care is critical to improving the health of the nation.

The experience of direct payments and individual budgets in social care shows that, by transferring control to service users, these kinds of self-directed approaches improve satisfaction, promote independence and improve value for money.

Putting patients In Control argues that it is time to end the institutional divide between health and social care that currently prevents self-direction being introduced into the NHS. It proposes the use of individual budgets for patients with long-term chronic conditions, such as mental illness and diabetes. This would give patients greater choice of treatment and allow them to develop their own package of care, mixing clinical and alternative therapies to meet their individual needs. Experience from the US shows that this can improve satisfaction, reduce the use of acute services and improve value for money. If consistent support is guaranteed to patients who choose to direct their own care, the report argues that self-direction can be compatible with the founding principle of fairness in the NHS.

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