Personal Health Budgets

What is a ‘Personal Health Budget’ (PHB)?

Information about Personal Health Budgets and the different types available can be found on the NHS England website https://www.england.nhs.uk/personalisedcare/personal-health-budgets/

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. The funds must be spent on meeting the health outcomes you will have agreed with your case manager in your support plan.

What does this mean for me?

The following groups have a legal right to have a PHB:

  • adults in receipt of NHS Continuing Healthcare,
  • children and young people eligible for continuing care
  • people eligible for aftercare services under section 117 of the Mental Health Act and
  • people eligible for an NHS wheelchair.

People who are eligible for a personal health budget can have a say over how their care is delivered to enable their health needs are met. If you have previously been in receipt of a direct payment through the local authority, you may be able to transfer this to a personal health budget. If you would like to find out more about having a personal health budget, please ask your case manager for more information.

There are three types of Personal Health Budgets:

  • Direct payments – you will receive funding to purchase a care package to meet the needs agreed between you and your case manager as part of your support plan, however you will be expected to provide information on how the funding has been used. Refer to the NHS England website for more information.
  • A notional budget – a notional budget is for individuals who do not want or cannot manage direct payments. This is a budget that will be managed on your behalf, and therefore, you will not receive funding directly to purchase a care package, but your case manager will advise on the amount of funding available to meet your needs.
  • A third party – funding is paid to a care organisation that holds the funds on your behalf and are responsible and accountable for the funding, care package and staff. The care organisation becomes the legal employer and will work with you to ensure the care package meets your needs.

Steps of the PHB process:

Step 1: Assessment of needs – your case manager will work with you to understand your health and wellbeing needs.

Step 2: Budget allocation – your assessment of needs is then used to calculate an ‘indicative budget’. An ‘indicative budget’ is an estimated amount of funding to meet your needs.

Step 3: Support planning – your case manager will liaise with you, and those you have chosen to support you, to ensure how best to use the personal health budget to meet your needs. This will include a choice of how care is delivered within the parameters of personal health budget funding.

Step 4: Arranging your support – when your care and support plan is agreed; we will help support you to commission the service or will facilitate this on your behalf.

Step 5: Review your support – your care and support plan will be reviewed regularly by a health professional to ensure it is meeting your needs. If there is a change in your needs, we will reassess the support you require.

Personal health budgets are part of the NHS’s comprehensive model of personalised care which will, as part of the NHS Long Term Plan, transform 2.5 million lives by 2023/24. To learn more please visit the Personalised Care pages.

  • A Personalised Healthcare Commissioning Clinician
  • Community nurse
  • Friends and family
  • A support broker
  • Personal PHB Officer

There are strict rules on what you cannot spend the funding on, more details of which can be found on the NHS England website, but for reference this includes (but not exhaustive);

  • 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.

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