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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.

(Guidance on the legal rights to have personal health budgets and personal wheelchair budgets)

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 and the same life options as people without complex health needs. 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. They do this by letting people know roughly how much money is available for their care and support and allowing flexible spend to meet people’s agreed health and well-being outcomes.

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.

Further to these legal rights, each Clinical Commissioning Group has their own local offer for who else is eligible in their area, which should be published on their websites.

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.

How to find out more

There is much more information about personal health budgets, and how they work in practice, in our four personal health budget information guides in the Resources section.

See also:

  • The NHS England Peer Leadership Development Programme offers information about personalised care, including personal health budgets. This free online programme is led by people with lived experience of personalised care, and is mainly aimed at people who could benefit from personalised care, for example: disabled people, people who have a long-term health condition and/or their family carer. Peoplehub co-wrote the programme, with NHS England, the Personalised Care Strategic Co-production Group and others. To request a course booklet, please email: england.pldp@nhs.net.

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