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Person-Centred Care toolkit

Personal Health Budgets

Background and overview

Personal Health Budgets (PHBs) aim to give individuals with long term conditions and disabilities in England more control over the money spent on their health and wellbeing needs.

A personal health budget is not new money, but rather enables people to use funding in different ways that work for them.

Health professional work collaboratively with PHB recipients to ensure budgets are spent on evidence-based approaches. Joint reviews are also integral to ensure PHBs are spent on progression towards reaching personal health goals.

Who can have a Personal Health Budget?

Adults in England who are eligible for NHS Continuing Healthcare and children in receipt of continuing care have had the right to have a PHB since October 2014. The expansion of Personal Health Budgets extends the option of a budget to all those who evidence indicates could benefit.

What are the key principles of Personal Health Budgets?

  1. The person knows how much they have available for healthcare and support within the budget.
  2. The person is involved in the design of the care plan.
  3. The person is able to choose how they would like to manage and spend their budget, as agreed in the care plan.

How do Personal Health Budgets work?

A PHB can be used for a variety of services, activities, personal care, equipment and therapies in order to meet agreed health and wellbeing outcomes. Collaborative Care and Support Planning (CCSP) is a pivotal aspect of the process to ensure that PHBs work well. A good care and support planning discussion will identify a person’s strengths, skills and personal circumstances as well as their health needs. It will identify what is working and not working from their perspective, what is important to the person and what is important for their health.

The individual knows upfront how much money they have available for healthcare and support. All personal health budgets must be agreed and signed off by the person’s NHS team. An important part of the personal health budget process is monitoring and review. This is a chance to look at whether the care plan is working for the person and their family.

How much money does an individual get in their Personal Health Budget?

The amount that someone receives in their personal health budget will depend on the assessment of their health and wellbeing needs and the cost of meeting these needs.

How is the money managed?

The person has the option of:

  1. Managing the money as a direct payment: The individual receives the funds via a payment card or into a dedicated bank account.
  2. A notional budget. No money changes hands. The NHS is responsible for holding the money and arranging the agreed care and support.
  3. A third party budget: A different organisation holds the money for the individual, helps them decide what they need, and then they support the individual to access the services they have chosen.

A combination of the above approaches can be used.

Are Personal Health Budgets Compulsory?

Personal health budgets are purely voluntary. No one will ever be forced to take more control than they want.

What can a Personal Health Budget NOT be used for?

A personal health budget cannot be used to pay for alcohol, tobacco, gambling or debt repayment, or anything that is illegal. It cannot be used to buy emergency care, primary care services or medication.

Are Personal Health Budgets safe?

PHBs involve individuals taking greater responsibility for their care and taking positive risks that can help them live a better life. Possible risks, and the plans for how they will be managed, need to be recorded in an individual’s care plan. Individuals can also plan for periods of fluctuation by recording the care and support they require when their condition deteriorates.

What is Integrated Personal Commissioning (IPC)?

Sitting alongside PHB is the Integrated Personal Commissioning (IPC) programme which will, for the first time, blend comprehensive health and social care funding for individuals, and allow them to direct how it is used. It is one of the pillars of the Five Year Forward View. The programme is aimed at those groups of individuals who have high levels of need, often with both health and social care needs.

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