Personal Health Budgets

A personal health budget is a set amount of money to spend on the support and services that will meet your health and wellbeing needs, as agreed between you (or your representative) and your local NHS team. It can be provided in a number of ways – including direct payments – to suit each person and their support plan.

You will be able to spend it on a range of activities, services and some types of equipment, tailored to you in order to meet your needs in way that suits you best.

Personal Health Budgets are not ‘new money’ but represent the opportunity to utilise money already in the NHS in a different way, to maximise impact and benefit of that money by personalising the way that people receive healthcare.

People with long term conditions and disability who are eligible for NHS Continuing Healthcare have a right to have a personal health budget if they wish. Children and young people with continuing care needs also have the right to have a personal health budget. We are now also able to offer a Personal Health Budget to people with learning disabilities and complex needs where they would benefit from one and we are working with the local authorities to develop joint processes for these
individuals.

For individuals receiving services from health and social care and/or Special Education Services where they are eligible for a personal budget from these organisations, the CCG can pay into an integrated personal budget to ensure holistic needs can be met. The CCG will continue to work with Local Authority colleagues and the rest of the local health economy to widen the Personal Health Budget offer to those with an Education, Health and Care Plan over the next three to five years, in line with national guidance.

Most of the money that could be used for Personal Health Budgets is currently tied up in ‘block’ contracts with providers of traditional NHS services. These will require to be separated in order to free the money from the system for individual budgets. The processes for doing this are complicated and therefore the expansion of Personal Health Budgets to cover these types of services will take time.

The aim of a personal health budget is to give individuals more choice and control over the money spent on meeting their health and wellbeing needs. PHBs support the vision of a more personalised, patient-focused NHS that recognises you as the expert in what is right for you. It allows you to have a conversation with your NHS Team as an expert of lived experience to ensure that the outcomes that matter most to you and the way that you would like your care delivered are the main focus of your care plan.

For more information and advice visit NHS England’s website.

No. You don’t have to change the healthcare and support if it is working well for you. But if there’s something that isn’t working, or maybe it could be improved if it was delivered in a different way, you can change that through a personal health budget.

If you think you may be eligible and would like to apply for a personal health budget, or would like more information about what a personal health budget involves, please contact the Leicester, Leicestershire and Rutland Personal Health Budget Team in the following ways:

• For personal health budgets for adults please email: Mlcsu.spallr@nhs.net
• For personal health budgets for children please email: Childrensipc.referrals@nhs.net

Or call 0121 611 0291 and ask for the Personal Health Budgets Team.

The CCGs in Leicester, Leicestershire and Rutland are currently led by National Guidance to determine who can have a personal health budget.  You will always be told how much money you will have before you start planning the things you could spend it on. The value of your package will be based on the cost of providing your care in a traditional manner.

The Continuing Healthcare Service is delivered by Midlands and Lancashire Commissioning Support Unit on behalf of the CCG and they are involved in the assessment for eligibility and identifying healthcare needs for adults with Continuing Healthcare needs and for children with Continuing Care needs.

The CCG employs children’s and adult’s nurses specifically for the purpose of assessing needs and support planning for personal health budgets. Based on these assessments and the recommendations, the CCG make decisions regarding the funding of packages and allocation of resources.

Leicester City Council, Leicestershire County Council and Rutland County Council currently provide direct payments to children and adults, many of whom are also receiving an element of their package or funding from the CCG. The local authorities are working jointly with the CCG to develop processes to facilitate the delivery of integrated personal budgets for those that are eligible.

Everyone with a personal health budget can get support to think though how they would like to use their budget to meet their health and wellbeing needs.

It is the responsibility of local NHS teams to advise people, and recommend a range of organisations who can offer local support. This is often described as brokerage.

A personal health budget can be spent on any care or services that are set out in the care and support plan that has been put together with the NHS team or voluntary organisation working with the person – and this needs to be agreed by the CCG (clinical commissioning group).

There are very few things that a personal health budget definitely can’t be spent on and the CCG will keep an open mind when considering what you would like to spend your budget on to meet your needs. As long as it is clear that the intervention is clearly documented in your support plan to meet your defined outcomes, is within budget, and does not pose any risk, then it is likely that your proposed plan will be accepted.

There are things that it would not be right for the Government to fund such as alcohol, tobacco, gambling or debt repayment, or anything that is illegal.

A personal health budget cannot be used to buy emergency care – for example if someone in receipt of a personal health budget had an accident, they would go to A&E like everyone else. You would also not use it to pay for surgical procedures.

A personal health budget also cannot buy primary care services such as seeing a GP, paying for dental treatment or buying medication.

In general your PHB cannot be used on anything that is considered unreasonable, that could cause harm, or that could bring the CCG into disrepute.

Yes. The CCG is currently working with the Local Authorities to develop joint assessment and planning processes that will facilitate an integrated budget across health and social care/education. Whilst this work is ongoing, it is still possible for you to join up your care by receiving a budget from social care/education and health, and using the funds to meet your needs.

If you are a child and you have an Education Health and Care Plan your personal health budget should be put together with any personal budget you may have from social care or education and your outcomes for each element of the budget would be set out in your Education, Health and Care Plan.

A Personal Health Budget can be issued in a number of ways with various degrees of responsibility. The NHS team will explain these options to you so you can make the right decision for you.

If your health changes or your plan is not right for you, you can look at it with your local NHS team and change things. You will always get NHS care in an emergency. You can go back to having NHS care like you did before if a personal health budget does not work for you.

For more information about personal health budgets, see our Personal Health Budgets information leaflet below

• NHS England’s Personal Health Budgets website

• Download an easy-read version of understanding personal health budgets

If you want any of this information in a different language or format such as large print, email communications@eastleicestershireandrutlandccg.nhs.uk.

Other sources of information:

• Skills for care