What makes integrated personal budgets for people with mental health problems work well?

Many of the things that make integrated budgets work are the same as those that make personal budgets or personal health budgets work, because so much of the infrastructure and the approach are shared – for example, information, advice and support, risk and so on.

Integrated budgets can be delivered without organisational integration but can be facilitated by it, as in the case of pooled budgets, shared IT and joint teams. But one does not have to wait for the other.

If the personal budget systems of the NHS and local authorities can be developed together, it could offer a powerful new way of integrating health and social care at the individual’s level, rather than across a whole population. By coordinating the service user experience, rather than using joint commissioning or pooled budgets as a starting point, integrated personal budgets could help to focus local efforts on what matters most.


Integrated personal budgets are new, so the evidence about what works is still emerging. The evidence we have accumulated comes from a number of related sources:

Based on these sources of knowledge, the following issues arise as central to the successful delivery of integrated personal budgets in mental health.

Flexibility, choice and control

Information, support and advice

'One-stop shop' for assessments

Good joint working

Systems integration

Some degree of systems integration helps to support integrated budgets. For example:

Financial arrangements

Integrated personal budgets need to be backed up by financial processes that enable mental health practitioners and users to access the budgets in a simple and relatively uncomplicated way. [24] It is helpful to have:

NHS Act 2006, Section 75

Section 75 of the NHS Act 2006 enables the delegation of functions and/or pooled funds to be spent on agreed objectives or specific services where each partner contributes. [25] One party can take the lead role in commissioning, whereby partners agree to delegate commissioning of a service to a lead organisation that acts on behalf of the other party. For example, a clinical commissioning group may manage a health budget and a local authority budget to achieve a jointly agreed set of aims, with the two budgets aligned under a single commissioning function. This may be a sensible option depending on the size and make-up of the service to be commissioned.

Section 75 also enables integration of provision, where resources and staff are combined to deliver a service from managerial level to the front line, with one party acting as the host. This allows the NHS to fund a local authority to carry out some or all of the duties associated with the delivery of personal health budgets.

Positive risk management

Brokerage and support services

Co-production, involvement and empowerment