Personal Health Budgets

Personal Health Budgets are about having greater control and choice over the care and support you receive, which can improve your health and wellbeing.

A Personal Health Budget is one way of receiving more personalised care: knowing how much money is available to spend should enable you to choose the services, equipment or therapies which best meet your needs.     

We already know that providing greater choice and control leads to better outcomes and enables people to remain independent for longer. Personal Health Budgets may therefore reduce the need for short-term health and wellbeing interventions, for example needing to visit a health clinic, allowing people to get on with their lives.

As such, Personal Health Budgets support Birmingham and Solihull’s health and wellbeing priorities to help vulnerable people in becoming more resilient and staying independent.

What is a Personal Health Budget?

A Personal Health Budget helps you know how much money you have available to spend on your health and wellbeing, which is planned between you and/or your representative or, in the case of children, your family or carer and your local NHS team. By working together with a healthcare professional, you will develop a personalised care and support plan which outlines how we can achieve your agreed goals.

Through this process you might decide to continue with your existing care and support or to do something different.

A Personal Health Budget should help people to get a better or different service, however it may not be right for everyone and you don’t have to have one if you decide it’s not right for you. 

This isn't additional funding on top of your existing support and care, it's about doing things differently, if there is a better way to meet your needs. If it is currently working well, then this doesn't have to change.

The NHS continues to be responsible for your care and will be on hand to support and guide you throughout.

How do Personal Health Budgets work?

Produced together with a Healthcare Professional, your personalised care and support plan is at the heart of making Personal Health Budgets work well. This plan will help you identify your health and wellbeing needs and goals, and together with your local NHS team sets out how the budget will be spent in order to achieve the best results for you.

If you have a Personal Health Budget you will be able to use it for a range of things, for example personal care, equipment or therapies. You may decide that traditional services work best for you, however, if they don’t you could also use your Personal Health Budget for an alternative activity which helps improve your health and wellbeing.  

You will not be able to pay for emergency care or care you usually get from your GP. You are also not allowed to spend the money on gambling, debt repayment, alcohol, tobacco or anything unlawful.

There are three ways you can manage your PHB:

Notional budget: No money changes hands. A budget is determined and, together with your NHS team, you decide on how best to spend it. They will then arrange the agreed care and support. Regular reviews will take place to ensure your personalised care and support plan is working well for you.

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 the care and support agreed in your personalised care and support plan.

Direct payment: The budget is transferred directly to you to buy the care and support you and your NHS team agree within your personalised care and support plan. You, or your representative, buy and manage services directly yourself. A regular review will take place to ensure that your personal health budget is meeting your needs and goals.

Who can have a Personal Health Budget?

Continuing Healthcare: Personal Health Budgets have been available in Birmingham and Solihull for adults and children and young people with continuing healthcare needs since October 2014. Anyone who qualifies for continuing healthcare will be eligible for a Personal Health Budget.

Mental Health: People who are referred for s117 funding (under the Mental Health Act) may be eligible for a Personal Health Budget. Your Care Co-ordinator may discuss this with you. 

Looked after children: Personal Health Budgets are currently being piloted for a defined group of Looked after Children who have had contact with specialist community mental health support in Birmingham. At present, referrals can only be accepted from a mental health practitioner.    

End of life care: Birmingham and Solihull CCG is currently undertaking a pilot with Heart of England NHS Foundation Trust to provide choice and control for individuals with a life limiting illness.

How can I get a Personal Health Budget?

By talking with a healthcare professional from your local NHS team, you can explore whether you believe a Personal Health Budget is the right choice for you. Below you will find a step-by-step guide:

  • Express an interest in Personal Health Budgets: You can either express an interest with your local NHS team, or a healthcare professional may ask whether you have considered a Personal Health Budget before.
  • Explore a Personal Health Budget in more detail: With a healthcare professional, usually during a face-to-face visit, you can explore whether you feel a Personal Health Budget might be right for you. Any questions about ongoing support the NHS provides, your future responsibilities and the process can be answered. You will have all the information you need to make an informed decision.
  • Calculate the indicative Personal Health Budget: If you decide a Personal Health Budget is the route for you, together with the healthcare professional, you will outline all your health and wellbeing needs. This information is used to calculate what your indicative budget will be. This will be explained and shared with you.
  • Developing the Personal Health Budget support plan: Central to your Personal Health Budget is your personalised care and support plan, which you develop with a healthcare professional. The plan helps you decide on your health and wellbeing goals and how your budget is best spent to achieve these.
  • Getting the Personal Health Budget plan agreed: Your Personal Health Budget care and support plan is agreed between you and the local NHS team.
  • Putting the Personal Health Budget plan in place: Once your support plan and the budget are confirmed, your plan can be put into action. In the case of a direct payment or third-party budget the Personal Health Budget contracts must be in place prior to any money being able to be paid. Your plan will detail which services, equipment or therapies you will need, who will support you in obtaining them and by when. You will be able to shop around to get the right services for you and in some cases these may be available via our online e-marketplace. 
  • Monitoring and review: To make sure that your personalised care and support plan is up-to-date and that the services you are using are meeting you needs and goals a regular review will take place.

Employing Personal Assistants

For a number of people opting to have a Personal Health Budget, the employment of a personal assistant is a great way to help manage their care and achieve agreed health and wellbeing outcomes.

Becoming an employer can be a daunting prospect, however there is support available to help you meet your responsibilities as an employer and to ensure that all legal requirements are met.

It is highly recommended that all personal assistants are contracted employees in line with HMRC guidance. This is to protect you as an employer and ensure your health and wellbeing needs are met in a safe and effective way.

If you’d like to find out more about employing a personal assistant, there are a number of information sources online.

Further Information

If you feel you may benefit from a Personal Health Budget and would like to know more, then please speak to your local NHS team and they will outline what the next steps are and support you throughout the process.

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