Personal health budgets (PHBs) in England have been viewed as a vehicle for developing a personalised patient‐based strategy within the substance misuse care pathway. In 2009, the Department of Health announced a 3‐year pilot programme of PHBs to explore opportunities offered by this new initiative across a number of long‐term health conditions, and commissioned an independent evaluation to run alongside as well as a separate study involving two pilot sites that were implementing PHBs within the substance misuse service. The study included a quantitative and qualitative strand. The qualitative strand involved 20 semi‐structured interviews among organisational representatives at two time points (10 at each time point) between 2011 and 2012 which are the focus for this current paper. Overall, organisational representatives believed that PHBs had a positive impact on budget‐holders with a drug and/or alcohol misuse problem, their families and the health and social care system. However, a number of concerns were discussed, many of which seemed to stem from the initial change management process during the early implementation stage of the pilot programme. This study provides guidance on how to implement and offer PHBs within the substance misuse care pathway: individuals potentially would benefit from receiving their PHB post‐detox rather than at a crisis point; PHBs have the potential to improve the link to after‐care services, and direct payments can provide greater choice and control, but sufficient protocols are required.

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NIMH's program evaluation studies assess the exlent and conditions utzder which services are provided according to community mental health center process goals of increasing quanti(v and range of service, decreasing use of state hospitals, responsiveness to needs, accessibiliO,, equiO', communiO, participation, and continuity and effectiveness of services. Completed contracts, annual inventories, and site visits indicate: (a) some developmeTzt of methods .for measuring processes," (b) evidence that the Centers Program is making progress toward some goals, [c) some suggestions of program options to facilitate this progress; (dj evidence that no goal has beet7 completely achieved; and (e) onh' a little evidence beyond that which initiated the Centers Program concerning the validiO, of the program's basic concepts.

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