Personal health budgets

 What is a personal health budget?

A Personal Health Budget (PHB) is an amount of money that is made available for an individual to spend on their healthcare and wellbeing needs. This enables them to choose which services they would like to use and who they would like to provide it.  The amount is agreed and provided by Clinical Commissioning Groups (CCG) – groups of GPs who commission NHS services in their local areas.  A PHB is not extra money, but is a different way of spending money that would already have been spent on providing care to the individual.

Who is eligible?

Anyone who is eligible for or receives NHS Continuing Healthcare funding (or Continuing Care for Children and Young People) has the right to ask to have a Personal Health Budget.

How does it work?

Once approval has been given for someone to have a PHB, their care plan is reviewed to ensure that it covers all aspects of the health and wellbeing support they need.  This process should involve key professionals and clinicians who provide care and the individual, or someone on their behalf. When the care plan is finalised, the budget required to provide the identified care needs will be calculated and agreed.

Those who are approved for having a PHB can request to manage it in one of three ways:

-Notional budget: the amount required is agreed and then the support outlined in the care plan is arranged and provided accordingly

-Real budget: held by a third party: the money is held by another organisation who help to identify, agree and arrange the support required

-Direct payment: the money is given directly to the individual and they can choose and purchase their own support.  They will be required to feed back to the NHS about what they have spent their PHB on.  

Within three months of the PHB being implemented, the care plan should be reviewed to ensure it is satisfactory and meeting the person’s needs.  Following this initial review, it should be reviewed on an annual basis as a minimum.  

How do I request a personal health budget?

Those who are interested in having a PHB should raise this with their Continuing Healthcare team. You should be able to find the contact details of your local team via the website of your CCG.

The local CCG should acknowledge receipt of the request within 10 working days, and provide a decision within a further 28 days.  In some more complex situations, the process may exceed these timeframes but the CCG should provide progress updates. Appeals or complaints on the decisions made can be addressed through the local NHS complaints system.

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Created: June 2015
Review due: June 2017

First published: Monday 29 June 2015
Updated: Tuesday 22 December 2015