A personal health budget (PHB) is the option to have the money you receive from the NHS for care and support, at the moment as continuing health care (CHC) funding, as a personal budget that can be spent creatively in a way that makes sense to you. From 1 April 2014, anyone in the U.K. who is eligible for CHC funding has the right to ask for a PHB and from 1 October 2014, everyone that is eligible have the right to have a PHB.
It is voluntary, nobody will force you transfer to a PHB if you don’t want to. At the moment, you have to meet CHC criteria to be eligible, however “Local NHS organisations will be free to offer personal health budgets to other people if they think an individual will benefit.”.1
What is a Personal Health Budget?
A personal health budget is “an amount of money to support your identified health care and wellbeing needs, planned and agreed between you, or your representative, and your local NHS team.”
Peoplehub elaborates very well on exactly how the planning process should work.
What can it be spent on?
“A personal health budget can be spent on any services or care which meets the individual’s agreed health and wellbeing needs. The services and care will need to be set out and agreed in a care plan. The only restrictions set by the Department are that personal health budgets cannot be spent on things that are inappropriate for the state to fund, such as alcohol, tobacco, gambling or debt repayment, or anything that is illegal.
At this time, some aspects of a person’s care will also be excluded from a personal health budget – primary medical services (i.e. GP services) and emergency services. As GPs provide a holistic service it was not felt appropriate to include this funding at this stage. This will very broadly cover the consultation and assessment functions that GPs perform things like diagnostic tests, basic medical treatment or vaccinations; however some services organised and managed by GPs, for example physiotherapy, counselling or nursing services could be included. Emergency services are also excluded from the budget as personal health budgets are unlikely to be appropriate in this context.”2
It is important to note that local authorities decide how they calculate a budget, have the power to restrict what a personal budget can be spent on, have the ability to impose additional criteria that has to be met to justify spending and have the full authority to add additional restrictions as they see fit. As such, personal health budgets are a postcode lottery and it might be worthwhile to ask your local Clinical Commissioning Group for their local policy and procedures before making a decision.
What is the process to receive a Personal Health Budget
Due to the regional differences there is no step-by-step process and the way a personal health budget is implemented vary greatly from person to person as well as between difference areas depending on local policy. The broad outline as I understand it is this:
- Request for PHB made and eligibility confirmed
- Indicative Budget is set by CCG and patient is informed
- Complete Aims and Outcomes official documentation
- Write up care/support plan and submit to CCG
- CCG checks plan against their local criteria, discuss issues in consultation with all parties involved and when an agreement is reached, signs off on it
- Final Budget is finalized, legal documentation is signed, a starting date agreed and funds are transferred in agreed fashion either through notional budget, third party or direct payments.
“We are the NHS England Personal Health Budget Delivery Team, supporting the national implementation of NHS personal budgets.”
“A community interest company providing peer-support for people interested in personal health budgets. Supporting change on a national level.”
Official site of the English NHS. All you need to know about health including: Health A-Z, lifestyle advice, directories, performance data & patient ratings.
Department of Health Leaflets & Documents
- Understanding Personal Health Budgets [Opens PDF]: “This leaflet will tell you about personal health budgets – what they are, why people with a long term health condition, staff in the NHS and the Department of Health think they could make NHS care better, and how to get more information.”
- Personal Health Budgets: First Steps [Opens PDF]: “This document sets out the principles of personal health budgets, reports on early lessons and invites expressions of interest in the pilot programme for personal health budgets.”
A guide to setting personal health budgets for people who are eligible for NHS Continuing Healthcare [Opens PDF]: “This good practice guide is for people working in the NHS who are implementing personal health budgets. It explains how to set budgets for people who are eligible for NHS Continuing Healthcare, based on learning from the personal health budgets pilot programme.”
- Personal Health Budgets: Experiences and outcomes for budget holders at nine months [Opens PDF]: “Fifty-two people with long-term health problems were interviewed nine months after being offered a personal health budget, as were 13 carers of budget holders three and nine months after the offer of a budget. Together they were drawn from 17 of the Primary Care Trusts (PCTs) that are currently piloting personal health budgets in England. These interviews suggest there is widespread potential for personal health budgets to lead to improvements in health and well-being. However, these benefits risked being reduced by delays and other problems in implementing personal health budgets.”