A personal health budget is an amount of money to support someone’s health and wellbeing needs, which is planned and agreed between the individual or their representative, and the local clinical commissioning group (CCG). It isn’t new money, but a different way of spending health funding to meet the needs of an individual.
Personal health budgets are a way of personalising care, based around what matters to people and their individual strengths and needs. They give people with long term health conditions and disabilities more choice, control and flexibility over their healthcare.
A personal health budget may be used for a range of things to meet agreed health and wellbeing outcomes. This can include therapies, personal care and equipment. There are some restrictions in how the budget can be spent.
Personal health budgets are part of the NHS’s comprehensive model of personalised care which will, as part of the NHS Long Term Plan, transform 2.5 million lives by 2023/24. To learn more please visit the Personalised Care pages.
Key parts of a personal health budget
Personalised care and support planning is essential to making personal health budgets work well. A personalised care and support plan helps people to identify their health and wellbeing goals, together with their local NHS team, and sets out how the budget will be spent to enable them to reach their goals and keep healthy and safe.
The person with a personal health budget (or their representative) should:
- Be central in developing their personalised care and support plan and agree who is involved
- Be able to agree the health and wellbeing outcomes* they want to achieve, together with relevant health, education and social care professionals
- Get an upfront indication of how much money they have available for healthcare and support
- Have enough money in the budget to meet the health and wellbeing needs and outcomes* agreed in the personalised care and support plan
- Have the option to manage the money as a direct payment, a notional budget, a third party budget or a mix of these approaches
- Be able to use the money to meet their outcomes in ways and at times that make sense to them, as agreed in their personalised care and support plan.
*And learning outcomes for children and young people with education, health and care plans.
Who can have a personal health budget?
Adults eligible for NHS Continuing Healthcare and children in receipt of continuing care have had a right to have a personal health budget since October 2014 and they should be the default option for these groups since 1 April 2019.
Since April 2016, there has also been an expectation that personal health budgets will become available for other groups of people, including people with a learning disability, autism or both.
Following a consultation run in 2018 by the Department of Health and Social Care and NHS England, where nearly 9 out of 10 people supported the proposals, from 2 December 2019 two additional groups of people have a legal right:
- People who are referred and meet the eligibility criteria of their local wheelchair service, and people already registered with the wheelchair service, when they require a new wheelchair either through a change in clinical needs or in the condition of the current chair. This group will have a right to a personal wheelchair budget to give them more choice and flexibility over the chair provided.
- People who are eligible for after-care services under section 117 of the Mental Health Act, which is the provision or arrangement of help and support for people who have been detained in hospital under sections 3, 37, 45A, 47 or 48 of the Mental Health Act 1983, when they leave hospital. For this group, a personal health budget may be considered whenever planning is taking place for section 117 mental health after-care needs during an admission to hospital, or at any assessment held to review the person’s section 117 after-care package of support in the community.
For information about personal health budgets in each local area, please refer to the local CCG’s website. All CCGs are required to inform eligible people about their right to a personal health budget.
Implementing personal health budgets and need more information?
NHS England and NHS Improvement provides an ongoing programme of support for all CCGs and other health and care professionals to support the provision of personal health budgets.
If you work within the NHS, a local authority or a voluntary sector partner, you can sign up to the Personalised Care Collaborative Network to access a range of resources, share learning and discuss issues with colleagues across the country.
For more information or access to the new network, please contact the national Personal Health Budgets team by emailing email@example.com.