A personal health budget is an agreed amount of money to pay for your NHS healthcare and support needs. You can develop a care plan with your local NHS team. A care plan looks at all your needs to make sure you receive the most appropriate care. Everyone with a long-term condition should have a care plan. You don't need to have a personal health budget. Your care can be provided by the NHS, just as it has always been.
What are personal health budgets?
A personal health budget is an agreed amount of money to pay for your NHS healthcare and support needs. The aim is to help people manage their care in a way that suits them. Anyone receiving continuing healthcare from the NHS will have a right to ask for a personal health budget. Everyone with a long-term condition should have a care plan.
The personal health budget is different from a personal budget and an individual budget. A personal budget is for your social care and support needs. An individual budget includes your social care and support needs and any other funding, such as being able to care for yourself.
The budget is planned and agreed between you and your local NHS team. Personal health budgets work in a similar way to the personal budgets that many people are already using to manage and pay for their social care.
How is a personal health budget planned?
You can develop a care plan with your local NHS team (which may include your GP or other healthcare professionals). A care plan looks at all your needs to make sure you receive the most appropriate care. Everyone with a long-term condition should have a care plan. The plan should set out:
- Your personal health and wellbeing needs.
- The health outcomes you want to achieve.
- The amount of money in the budget, and how you are going to spend it.
What can the personal health budget be used for?
The budget can be used for a wide range of services, depending on your needs. These services may include therapies, personal care and equipment. The budget cannot be used to pay for emergency care, or the care you normally receive from your GP. A personal health budget can be spent on services recommended by your GP, like physiotherapy.
You don't have to change any healthcare or support that is already working well for you. You can change something that isn't working well. Once you have a personal health budget, you can also change your care plan if your health changes or something in your plan isn't working for you.
You cannot add your own money into a personal health budget. The personal health budget should meet all your health needs. If you want to spend your own money on extra services, you need to organise and pay for this yourself. This would be separate from the personal health budget.
Who can have a personal health budget?
A personal health budget will be offered to people having NHS continuing healthcare, which is NHS-funded long-term health and personal care provided outside hospital. To have NHS continuing healthcare, you must have a medical condition that needs ongoing care. The main need for care must be a problem with your health.
Children, young people, adults and older adults who are living at home and are having NHS continuing healthcare, can have a personal health budget.
Local NHS organisations will be able to offer personal health budgets to other people if they think the person will benefit. The aim is to introduce a right to a personal health budget for all those people who would benefit from it.
You can have a personal health budget if you already have a personal budget for social care and support.
Who decides who can have a personal health budget and what it can be spent on?
Your local NHS will set up local systems for deciding who can have a personal health budget, how big the budget will be and what it can be spent on. These will depend on which groups of people it is working with and which services are included.
Those involved with making these decisions may be a GP, a community matron, a community psychiatric nurse or another health professional.
How can a personal health budget be managed?
Once your care plan has been agreed, the money can be managed in different ways:
- Notional budget. No money changes hands. You talk to your local NHS team about the different ways to spend the money on meeting your needs. They will then arrange the agreed care and support.
- Real budget held by a third party. A different organisation or trust holds the money for you and helps you decide what you need. The organisation then buys the care and support you have chosen.
- Direct payment for healthcare. You receive the cash to buy the care and support you need. You buy and manage services yourself; or your representative can do so on your behalf. You have to show what you have spent it on.
You will need a separate bank account to receive a personal health budget by a direct payment. This account must only be used for your personal care. The same bank account can also be used for receiving and managing a social care budget or Independent Living Fund payments.
If you don't want to or are unable to manage a budget yourself, someone else can manage the budget on your behalf, such as a carer.
Do you have to have a personal health budget?
You don't need to have a personal health budget. If the personal health budget does not work for you, your care can be provided by the NHS, just as it has always been.
Dr Colin Tidy
Dr Colin Tidy
Dr Hayley Willacy