What is a Personal Health Budget?
A personal health budget is an amount of money used to support your health and well-being needs, as agreed between you and your NHS team. Personal health budgets are available for adults and children.
A personal health budget allows you to have more choice and control about how your health and well-being needs are met and you can be flexible about what your support looks like
How Personal Health Budgets work
An estimated budget will be calculated, and a care and support plan will be developed with you and your NHS team to determine your health and wellbeing outcomes.
There are three options for managing that money:
1. Notional budget:
No money is given to you directly. You will be informed how much money is available to meet your assessed needs and together with your NHS team, you decide how to spend that money. The NHS Team will then arrange the agreed care and support for you.
2. Third party budget:
An organisation legally independent of both you and the NHS (for example, an independent user trust or a voluntary organisation) holds the money for you and pays for and arranges the care and support as identified within your care and support plan.
3. Direct payment for healthcare:
You receive the money to buy the care and support you and your NHS team agree you need. You must show what have spent it on, but you, or your representative, buy and manage services yourself.
It is important that you choose the right option for you, as agreed with your NHS team.
Who can have a Personal Health Budget?
The right to have a personal health budget applies to people who are:
- Adults receiving NHS continuing healthcare (NHS funded long-term health and personal care provided outside hospital)
- Children receiving NHS continuing care.
- People who are referred and meet the eligibility criteria of their local wheelchair service and people who are already registered with the wheelchair service, when they need a new wheelchair or specialist buggy, due to a change in clinical needs, or due to the condition of the current chair. These people will be eligible for a personal wheelchair budget. (Available from your
- local commissioned wheelchair service).
- People with a mental health condition who are eligible for section 117 aftercare as a result of being detained under sections of the Mental Health Act (this does not include detention under section 2 of the Act).
What can you use your Personal Health Budget for?
You can spend your personal health budget flexibly on things that help to meet the outcomes as agreed in your care and support plan.
This may be things like your everyday personal care and meeting your nutritional requirements or support for doing things to help keep you both physically and mentally healthy. There are, however, things that you cannot use your budget for:
- Alcohol
- Tobacco
- Gambling
- Debt repayment
- Anything illegal or something which could damage your health.
- Primary care services such as on GPs, emergency or acute health services
What can you expect?
Someone with a personal health budget (or their representative) should:
- Be central in developing theirs personalised care and support plan and agree who is involved
- Be able to agree the health and well-being outcomes (and learning outcomes for children and young people with education, health and care plans) they want to achieve, together with relevant health, education and social care professionals
- Get an upfront indication of how much money they have available for healthcare and support. HIOW ICB uses Imosphere Formulate to calculate the indicative budget (There may be flexibility when an indicative budget is discussed as part of a one-off budget)
- Have enough money in the budget to meet the health and well-being needs and outcomes (and learning outcomes for children and young people with education, health and care plans) agreed in their personalised care and support plan
- Have an option to manage the money as a direct payment, a notional budget, a third party budget or a mix of these approaches
- Be able to use the money to meet their outcomes in ways and at times that make sense to them, as agreed in their personalised care and support plan. HIOW ICB use People Places Lives Virtual Wallet as the finance delivery system for PHB holders.
Find out more about Personal Health Budgets in the video from NHS England.