Personal Health Budgets

A personal health budget (not to be confused with a personal budget, although the two can be combined) is an amount of money allocated to you by the NHS to meet the costs of your assessed healthcare and support needs.

This initiative, currently being rolled out, was created to give people more information on and control over how their needs were being met, as part of a process called self-directed support, which was itself part of the wider approach of personalisation. From April 2014, people already receiving NHS Continuing Healthcare will have a right to ask for a personal health budget.

How is the amount calculated?

The eligible healthcare needs of the individual are evaluated by their NHS team, and a ‘care plan’ is developed and agreed on. This care plan is made up of all the various healthcare supports which you have been assessed as needing. The total costs of these agreed supports make up your Personal Health Budget.

How can I receive it?

The recipient is encouraged to take as much or as little control over their Budget as they wish to.

Some people prefer to leave the practical organising of healthcare to their local NHS team. They would be kept informed throughout the process, would have the right to request change in certain aspects of their care, and the NHS would be responsible for using the Budget to arrange and pay for any assessed healthcare needs. Alternatively, a ‘user-controlled trust’ can be set up, within which the personal health budget would be managed by a third-party.

Some people prefer to take more personal control over their budget, and arrange their care themselves. This is made possible through the provision of a direct payment, which is the direct transferring of the personal health budget to the individual via a cash payment. The individual then takes responsibility for the organisation and payment of meeting their assessed healthcare needs.

A combination of the above two levels of control is also possible, within which individuals would organise some of their care themselves with funding from a direct payment, and leave the remainder to be arranged by the NHS. Brokerage services to provide independent support throughout this process are also widely available, with the overall aim being to help the individual achieve the level of control which works best for them.

What may it be used for?

A personal health budget is used to meet the healthcare needs of the individual, and is in this way different from a personal budget, which is used to meet social care and support needs.

Your personal health budget may be used on any healthcare service set out and agreed upon in your care plan. This may include medication, nursing care, physiotherapy and so on.

What may it not be used for?

A Personal Health Budget may not be used to pay for anything which is not directly meeting your eligible healthcare needs.

It may not be used for things considered irresponsible for the government to fund. These generally include alcohol, tobacco, gambling, debt repayment, and anything which is illegal.

Personal Health Budgets also may not be used to address social care needs, which are the responsibility of your local council.

Will I need to pay anything towards it?

No. You cannot spend your own money on NHS care. You may if you wish purchase extra services which are not contained within your care plan, but this would be considered separate from your Personal Health Budget, and would need to be entirely organised and funded by you.

Can I combine my Personal Budget and my Personal Health Budget?

It may be possible to combine the two, and thus further streamline your own funding system. If you wish to explore this possibility, you should ask the person who is organising your personal health budget. In some cases, the assessment, planning and monitoring areas may similarly be joined up.