Personal Health Budgets
What is a personal health budget?
“A personal health budget is an amount of money to support a person’s identified health and well-being needs, which is planned and agreed between the person, their representative, or, in the case of children, their families or carers and the local NHS team. It is not new money, but money that would normally have been spent by the NHS on a person’s care being spent in a more flexible way to meet their identified needs. The use of personal health budgets is one way of providing more personalised care and means tailoring services and support for people to enable them to have choice, control and flexibility over their care.“
Personal health budgets are one way that people with long term health conditions and disabilities are able to have more choice and control in their own lives. It is part of a movement for change, driven by people themselves, to be able to have a more “ordinary” life. What’s exciting about personal health budgets is the coming together of the disability rights movement with NHS policy on personalised care.
Often when people have long term health conditions and disabilities, the way the health and care system has traditionally planned and delivered their care has limited people’s choice and control. Personal health budgets redress this by moving power and decision making closer to people.
Who can have a personal health budget?
Currently there are three groups of people who have a legal “right to have” a personal health budget. These groups are people who are eligible for:
- NHS Continuing Healthcare and Children’s Continuing Care
This is funding for a very specific group of people who have been through a formal assessment process, which has identified a primary health need. It is based on an assessment of your overall needs which is carried out using a National Decision Support Tool.
- Section 117 after-care under the Mental Health Act
People are eligible for Section 117 after-care if they have been detained under sections 3, 37, 45A, 47 or 48 of the Mental Health Act 1983. When they leave hospital, Section 117 after-care services traditionally include healthcare, social care and employment services, supported accommodation, and services to meet people’s social, cultural and spiritual needs.
- NHS wheelchair services
People who are referred and meet the eligibility criteria of their local NHS wheelchair service, and people who are already registered with the wheelchair service, are eligible for a personal wheelchair budget when they require a new wheelchair or specialist buggy, either through a change in clinical needs or in the condition of the current chair.
The key features of a personal health budget
We know that even the best initiatives can go wrong without people’s input into quality indicators and feedback about how things are working on the ground. The six key features of personal health budgets were co-produced by personal health budgets holders working with the NHS. They serve to help people recognise if what they are being offered is a true personal health budget.
A person should:
- Be central in developing their personalised care and support plan and agree who is involved
- Be able to agree the health and well-being outcomes (and learning outcomes for children and young people with education, health and care plans) they want to achieve, in dialogue with relevant health, education and social care professionals
- Know upfront an indication of how much money they have available for healthcare and support
- Have enough money in the budget to meet the health and well-being needs and outcomes agreed in the personalised care and support plan
- Have the option to manage the money as a direct payment, a notional budget, a third-party budget or a mix of these approaches
- Be able to use the money to meet their outcomes in ways and at times that make sense to them, as agreed in their personalised care and support plan.
We have created a series of guides and information packs to offer realistic and useful information to individuals and families, so that people are better equipped to ask relevant questions and make the choices that are right for them about their health and well-being. The guides are intended for people who want to know more and who are considering having a personal health budget, and may also be useful for professionals.
This first guide provides some key information about personal health budgets. It explains what they are, who can have one and how you might start the process of applying for one.
This second guide is about the critical process of care and support planning. It explains what a care and support plan is, what you need to know to be able to write your plan, and the essential elements that should be included.
This third guide explores the different ways that personal health budgets can be held, and the options for managing the money and the responsibilities.
This fourth guide provides some ideas and tips for getting and managing a personal health budget, and for working with the health professionals who are supporting you.
This first pack focuses on what the NHS Continuing Healthcare assessment is, including: what kind of needs may be eligible, how these needs are assessed and what happens if you are not eligible, or if you become ineligible at a later stage.
This second pack focuses on the NHS Continuing Healthcare assessment itself, including: what you should be able to expect of a good assessment, what information you should gather and how you can best prepare for the assessment.
These next guides below were part of the original personal health budget toolkit, collating learning from the pilot programme. Although written in 2012, and aimed at professionals implementing personal health budgets in the NHS, we feel they contain useful information for individuals and families too.
This guide aims to share learning around good quality advice, advocacy and brokerage functions and how they can support a shift in power and decision making, within a clear partnership.
This guide is about what works for families who use a third party organisation to manage their personal health budgets, and is written by people with direct experience of personal health budgets.
This good practice guide outlines learning and approaches in relation to the delegation of tasks to personal assistants for personal health budget holders.
Personal Health Budgets:
NHS Continuing Healthcare and Children’s Continuing Care: