Personal health budgets for Continuing Healthcare
Personal health budgets are one way to have more choice and control of your healthcare and support.
Ways to help you get the NHS care you want
If you are referred for outpatient treatment you have a legal right to:
- choose the organisation that provides your treatment
- information to help you understand the treatment you need so that you can choose well
- help to make a care plan to make sure you get the right care for your needs.
What is a personal health budget?
A personal health budget is the amount of money the NHS sets aside to pay for your individual healthcare and wellbeing needs.
You, or someone representing you, can work with your local NHS team to plan how to spend your personal health budget.
If you have a personal health budget, you will be able to use it for a range of things to help you meet your goals, such as therapies, personal care and some equipment. Your budget will not be used to pay for emergency care and your normal care from a family doctor, which you will get in the usual way. You are not allowed to spend the money on gambling, debt repayment, alcohol or tobacco, or anything unlawful.
You don’t have to change the healthcare and support that is working well for you, but if there’s something that isn’t working, you can change that.
At the centre of your personal health budget is your care plan. This plan helps you decide your health and wellbeing goals, together with the local NHS team who support you, and sets out how your budget will be spent to enable you to reach them and keep healthy and safe.
Personal health budgets work in the following ways, or a combination of them:
Real budget managed by a third party organisation
This is when you know how much funding is available to you but a third party organisation looks after the money on your behalf. The third party organization, such as ecdp (see page 12) will work with you to decide what you need, and then buys the services you have chosen
This is when you understand the amount of money set aside for your healthcare and, with the help of your NHS Clinical Commissioning Group (CCG), you have a say in how this money is spent. The CCG will continue to commission services and manage healthcare contracts on your behalf. This option may be for you if you are happy with the way your needs are being met at the moment.
Direct healthcare payment for people with capacity
This is when you receive the funding that is set aside for you as a direct health payment for you to manage (with or without assistance). You can either receive and manage the payment, buying and managing the healthcare services yourself, or decide for it to be received and managed by a person of your choosing (a nominee).
If you choose a nominee, that nominee becomes responsible for managing the payment, and buying and managing the service. The nominee is responsible for the money and all aspects of the direct payment and has to show what the money has been spent on.
Direct healthcare payment for people who lack capacity
This is when you are not able to make decisions about your own healthcare. A representative (agreed by the CCG), will receive the funding that is set aside for you as a direct health payment.
The agreed representative is responsible for managing the payment, and buying and managing the service. The representative is responsible for the money, and has to show what the money has been spent on.
The representative must involve you and act in your best interests.
The main things to know about personal health budgets
- You do not need to use your personal health budget to pay for services from your GP or emergency health services.
- The NHS stands by its promise that it is there for everyone, based on need, not ability to pay.
- The NHS care and support you get should be safe, effective and compassionate.
- Personal health budgets should help people who may not always find it easy to get the best out of the NHS to get a better service.
- You will not have to get healthcare in this way if you do not want to.
- You should have as much control over decisions as you want.
- NHS and social care organisations should work in partnership with you and with each other.
Who can have a personal health budget?
Anyone receiving NHS Continuing Healthcare can have a Personal Health Budget.
Who decides if I can have a personal health budget, how big the budget is and what I can spend it on?
Ask your Continuing Healthcare team, GP, district nurse, community matron, or another medical or social care professional for more information about this.
Can I have a personal health budget for Continuing Healthcare as well as a personal budget for care and support?
Yes, but only if you are a child or young person who is eligible for continuing healthcare and also receiving a personal budget from social care.
Will I be responsible for my own care? What happens if something goes wrong or my needs change?
You will not be left to take care of everything. You and your family and carers or representative will need to agree a care plan with your local NHS team. Your care plan sets out your health and wellbeing goals, and how your budget will be spent to enable you to reach them and keep healthy and safe. Your local NHS team can give you advice about planning if you want it, and will give you an indication of your budget and explain the basis on which your care plan is agreed.
You can review and update your care plan with your local NHS team when you need to - for example, if your health changes or something in your plan isn’t working for you.
In an emergency, you will get NHS care as normal. And if having a personal health budget does not work for you, your local NHS will provide the care you need as it does normally.
Will this mean means-testing for health?
No. The personal health budget should be enough to meet your needs in the way you have agreed without you having to spend your own money.
What do I do if I want a personal health budget?
Talk to your local NHS Continuing Healthcare team. They should be able to help you find out more about personal health budgets. Even if they are not, you can talk to them about other ways to make sure that you get the healthcare and support that works best for you.
If you have more questions, or would like more information, please:
Go to the Department of Health websites: www.dh.gov.uk/personalhealthbudgets and www.dh.gov.uk/health/category/policy-areas/nhs/personal-budgets/
Talk to ecdp, a disabled people’s organisation based in Essex, which has been funded by your local NHS to provide information, advice and guidance to people using and thinking about using personal health budgets for Continuing Healthcare.
Visit www.ecdp.org.uk/personalhealthbudgets or contact ecdp:
By telephone: 01245 392 300
By email: firstname.lastname@example.org
By textphone: 01245 392302
By post: ecdp, Ivan Peck House, 1 Russell Way, Chelmsford, CM1 3AAI
f you want to share experiences, advice and support with other people who have a personal health budget, their carers and families, you can visit the peoplehub website:
NHS Choices helps people find reliable information about treatments, conditions and healthy living, and to comment on their own hospital experience.
For more information about the right to choose where you get treatment, ask your GP or CCG or visit: visit NHS Choices
Your health, your way (also called the patients’ prospectus) supports people to take a more active role in decisions about their care, control their condition better, and have a better quality of life.
Information Prescriptions are a quick and easy way to provide information about your condition and local services.