Personal Health Budgets

A personal health budget is an amount of money to support your health and wellbeing needs. This is planned and agreed between you (or someone who represents you) and NHS Cheshire and Merseyside and in some cases your local council .

Your personal health budget can be completely funded by the NHS

or

You can have an integrated budget, this is where money from the NHS and your local authority is put together to meet your health and social care needs and sometimes education needs.

There are three different ways to hold your personal health budget:

• a notional budget - no money is given to you directly. You find out how much money is available for your assessed care and support needs and together with your NHS team you decide how to spend that money. The NHS will then arrange your agreed care and support services.
• a third party budget - this is where an organisation legally independent of both you and the NHS (for example a voluntary organisation) holds the money for you, and also pays for and arranges the care and support agreed in your care plan.
• a direct payment - you get the money to buy the care and support you and your NHS team agree you need. You must show what you have spent it on, but you, or your representative, buy and manage services yourself.

A direct payment gives you the most control over what services you can choose to provide your care and support.

A personal health budget gives you lots of advantages and puts you in control of your care and support. You will: 

• be able to choose how your budget is held and managed
• be able to agree your and health and wellbeing outcomes with the NHS
• know how much money you have for your care and support
• be able to create your care and support plan with help from the NHS
• be able to spend your personal health budget in ways and at times that make sense to you and which are agreed in your care and support plan

NHS Cheshire and Merseyside must follow the national guidance from NHS England to determine who can have a personal health budget

• Adults receiving NHS continuing healthcare, this is often called CHC funding
• Children and young people receiving children and young people's continuing care funding
• People who meet the eligibility criteria of their local wheelchair service and who are long term users of wheelchairs can have a personal wheelchair budget
• People who are eligible for section 117 aftercare services
• Children and young people with education, health and care plans aligned to expectations in the SEND Code of Practice. 

A care and support plan says:

• the type of support you need
• how this support will be given
• how much money the NHS will spend on your care

Making a care and support plan is a very important step in the personal budget process. Your care and support plan shows what matters to you and what you want to achieve rather than what is wrong with you.

• The person who owns the plan has a big part in writing it
• It includes a description of the person, what matters to them and all the details of how they will achieve their health outcomes and goals
• It makes sense to the person who owns it
• It is flexible and adapted to a person’s health condition, situation and needs
• It says what will happen in an emergency
• It says how much money the person has to pay for the services in the plan

All care and support plans and budgets must be lawful, appropriate, and effective and demonstrate value for money.

You should:

• feel empowered and build your knowledge, skills and confidence around managing your care and support needs
• feel confident that the process and the care and support plan will deliver what matters most to you
• be at the centre and agree who is involved in making the care and support plan
• be seen as a the expert in your own life, including skills, strengths, experience and relationships
• be valued as an active participant in conversations and decisions
• know what to expect in the care and support planning process
• have clear information and advice at the times you need it
• be helped to develop your care and support plan in a place which suits you
• feel listened to and understood and find you are building trusting and effective relationships with key people
• have the chance to agree your health and wellbeing outcomes with any health, education and social care professionals
• be happy with your care and support plan and can review it before it is finalised

Everyone with a personal health budget will be offered support to think through how they would like to use their budget to meet their health and wellbeing needs.

Your budget can only be spent on the care and support set out in your care and support plan and agreed with the NHS.

Things that it would not be right for the NHS/Government to fund:

• alcohol, tobacco, gambling or debt repayment, or anything that is illegal.

Also the plan cannot be used to purchase any emergency, primary care and other universal care services.

The NHS will make sure you get help to have a personal health budget and to manage your direct payment.

We’re here to make life better for carers – Carers UK