Singing for your succour

GETTING away from it all by the seaside, going for a long walk with the dog and singing have long been seen as wonderful for wellbeing, but hardly medicinal. Until now.

In a few month’s time, some long-term sick and disabled people will be entitled to ask the NHS for money allocated to their ongoing care to be spent on improving their health in the way they see fit. With input from their health care clinicians, patients could choose to spend the money in these personal health budgets on anything from the traditional care they have always had, to buying a dog for companionship and exercise, singing classes to help improve breathing problems, or even booking a quiet break away from the stresses of life.

“The idea is that you can do anything with it that meets your health needs,” says Vidhya Alakeson, mental health lead for NHS England’s personal health budgets delivery programme, and author of the newly-published Delivering Personal Health Budgets.

“You identify what your health goals are and how you might meet them.

“The guidelines have very few restrictions, so anything that’s legal and isn’t alcohol, cigarettes- or-whatever is allowed.”

Alakeson also stresses that those entitled to their own personal health budgets will still use their GP, be prescribed medicines and be admitted to hospital as usual.

“It’s really important that people understand this is not saying, ‘We are going to take all the money we would have spent on you in the NHS and tell you to get lost and sort it out for yourself.

That’s a fear that people have about this.

But personal health budgets are just the money that’s spent on people’s ongoing needs.”

Pilot schemes of such budgets ran throughout the country from 2009 to 2012 with very positive results. Successful examples include people with mental health conditions, who in the past had ended up in hospital, using their budgets to stay in B&B accommodation.

“What they need is a place to go to when they are feeling distressed, where they’ve got an agreement with a B&B owner and can have quiet and maybe walk on the beach, instead of using a hospital inpatient bed,” explains Alakeson.

“It’s much cheaper, and because people with mental health problems often don’t really want to be in hospital, the outcomes tend to be better too.”

People can also use the money to join a gym or buy exercise equipment to manage their weight – like a man with motor neurone disease who bought an adapted bike to help him remain active and slow his deterioration.

Massage and alternative therapies such as reiki can also be chosen to help manage pain, or to help people with mental health conditions to relax.

Music and singing was another popular option on the pilot schemes. A man who would previously have gone to a hospital-based rehabilitation programme for the long-term lung disease COPD chose to have singing lessons instead to stabilise his breathing.

“This also had the spin-off of being a lot more sociable, so rather than being lonely and isolated at home, the person was able to get involved with singing groups and develop friendships,”

says Alakeson.

“By breaking out of the hospital-based service, you can get a lot more community connection for people, so it has a double positive.”

Tina Warnock, a spokesperson for the British Association of Music Therapists (bamt.org), goes on to explain even more benefits of singing. As well as increasing the release of oxytocin, which promotes feelings of trust and emotional wellbeing, singing also helps improve breathing, which can aid relaxation.

Singing has additionally been found to be beneficial for people with dementia, and mental health problems such as depression.

‘SINGING has been increasingly recognised in recent years as being beneficial to both physical and mental health,” Warnock says.

The benefits from owning a dog are equally championed by the Dogs Trust charity (dogstrust.org.uk), which has compiled a Canine Charter for Human Health from research studies. Dogs Trust veterinary director Paula Boyden says research shows that on top of reducing loneliness and depression by providing companionship, owning a dog can boost the immune system, reduce blood pressure and subsequently reduce the chances of a stroke.

“Dogs Trust has always promoted the health benefits of owning a dog,” she says. “It has been proven that dog owners make fewer visits to GPs too, so we have launched our Dog Prescription to encourage more GPs and health workers to prescribe a daily dose of dog.”

Amid all the clear strengths of personal health budgets though, there is one negative – namely the fear that people may abuse the money they are given.

But Alakeson is keen to point out the pilot schemes proved no need for such concerns, partly because there are many checks and balances, such as money not always being paid up front. Receipts also have to be provided when goods or services are bought with the personal health budget (which will usually be given in monthly or quarterly payments) “to reduce the risk that someone might take all the money up front and spend it on a trip to Vegas”.

“People get this money because they have a condition that needs to be managed, and they have a strong incentive to use it well,” Alakeson argues. “Rather than frivolous expenditure, what you see is that people are much more prudent with the money than the system is, as they have a vested interest in spending it well, and often feel quite grateful for the opportunity to do something different with it.”