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The extension of personal budgets in social care and health

BMJ 2010; 341 doi: (Published 24 November 2010) Cite this as: BMJ 2010;341:c6696
  1. Bob Hudson, visiting professor in public policy
  1. 1School of Applied Social Sciences, University of Durham, Durham DH1 3JT, UK
  1. bob.hudson{at}

The personal budget model will be rolled out but the evidence base is contested

The government has now published its consultation paper on adult social care,1 with a proposed framework for an outcomes based approach to assessing progress.2 A key component of the documents is a commitment to extending the number of people using personal budgets to purchase their care. The proportion of people using community based services who have a personal budget increased from 6.5% in 2008-9 to 13% in 2009-10, and the government wants to make this the norm by 2013 for everyone receiving care and support.

A personal budget can be taken as a direct (cash) payment, as an account held and managed by the local authority in line with the person’s wishes, or as an account placed with a third party provider and used when needed rather than according to a pre-set plan. It is the cash payment option that the government wants to see developed. The model has been used most successfully by adults with physical disabilities. Drawing on reports of successful implementation,3 4 5 the government identifies five other groups …

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