MLCSU CHC
curve

What is a ‘Personal Health Budget’?

A personal health budget is an amount of money, paid to you by the NHS to meet your healthcare and wellbeing needs. You will be able to use your budget for a range of things to help you meet your goals and improve quality of life. There are three types of personal health budgets:

  • Direct payments – you get the cash to buy the services you and your care manager/ coordinator agree you need. You must show what you have spent it on, but you buy and manage your services yourself. You can also use a managed account service to manage your bank account however you will still be an employer for the Personal Assistant’s (PA’s)/ employees/carers.
  • A notional budget – you do not get any cash, but your care manager/ coordinator/ nurse will tell you the money available to meet your needs. A notional budget is for individuals who do not want or cannot manage direct payments. You and your care manager will then agree what services you want to pay for.
  • A real budget held by a third party – this is where the money is paid to an organisation that holds the money on your behalf. This is set up to manage the budget on your behalf and be accountable for the money and the staff. The company becomes the legal employer, but you still have control of the PA’s.

Step 1: Assessment of needs – Your care manager will ask you questions to find out what you need for your health and wellbeing.

Step 2: Budget allocation – Your assessment of needs is used to calculate an ‘indicative budget’. An ‘indicative budget’ is an estimated amount of money needed to meet your health and wellbeing needs.

Step 3: Support planning, care planning and using the budget – Your care manager/ nurse will then work with you, and those who support you, to decide how best to use the personal health budget to meet your needs. This will include your choice of how care is delivered.

Step 4: Arranging your support – When your support plan is agreed; we will support you to put in place the services agreed in your care and support plan.

Step 5: Review Your support – Your plan will be reviewed regularly by a health professional to ensure it is meeting your health outcomes. If your needs change or your support is not meeting your needs, you will need a reassessment of your needs to ensure the support you are receiving is working well. This is written in a care/ support plan, which both you and your care manager must sign. While it can take some time to set up your health budget, we will make sure that this doesn’t cause a delay in being discharged from hospital and an interim care package will be offered through a care provider.

Who can help me plan my support?
  • A Personalised Healthcare Commissioning nurse
  • Community nurse or clinical case manager
  • Friends and family
  • A support broker
What can a PHB be spent on?

The money must be spent on meeting the health outcomes you will have agreed with your care manager/ nurse. You cannot spend the money on:

  • Anything illegal
  • Statutory services
  • Purchasing primary medical services provided by GP’s
  • Covering urgent or emergency treatment or admissions to hospital
  • Employing people in ways which breach employment regulations
  • Purchasing goods or services which do not meet agreed outcomes
  • For Continuing healthcare (CHC) funded: everyday household costs that are expected to be covered by personal income or through welfare benefits (e.g. food, rent/mortgage interest, fuel, clothing and other normal household items).
What if I’m unable to look after the money myself?

Your carer or a family member can support you, or you could choose a managed account service advised by the CCG.

What does this mean for the citizen/patient/service user?

People who are eligible for a PHB will have much more say over how their health and wellbeing needs are met. If you are receiving direct payments through social services, you may be able to transfer to personal health budgets with minimal or no disruption to your current arrangements. If you would like to find out more about having your personal health budget, please ask your care manager/nurse for more information. You may choose to keep your existing services exactly as they are, but this is subject to a review of your current care needs.