This briefing outlines the availability of Personal Health Budgets (PHBs) in England. In December 2019, NHS England extended eligibility for PHBs to wheelchair users and people who qualify for after-care services under 117 of the Mental Health Act.
What are Personal Health Budgets?
A Personal Health Budget is an amount of money used to support a person’s identified health and wellbeing needs. It is planned and agreed between the person and their local NHS team. Personal Health Budgets aim to give people greater choice, flexibility and control over the health care and support they receive. They also provide an opportunity for people to work in equal partnership with the NHS about how their health and wellbeing needs can best be met. In terms of funding, Personal Health Budgets are not about new money, but about using current resources differently.
Who can access Personal Health Budgets?
Personal Health Budgets are being rolled out across England, with over 70,000 patients already utilising them. Currently, about 30% of the population qualify for the right to have a PHB. Under current legislation, those with the ‘right to have’ include:
- Adults in Continuing Healthcare,
- Children in Continuing Care,
- Children with an Education, Health and Care Plan (EHCP),
- Wheelchair users,
- People that qualify for after-care services under s117 of the Mental Health Act.
Funding for PHBs combines social care and NHS funds, requiring councils and the NHS to work together to provide integrative care.
How does a PHB differ from normal care provided by the NHS?
Personal Health Budgets give patients more control over decision making when it comes to their health and care needs. They provide a way for patients to access services that best suit them. A person with a PHB will be central in developing their personalised care and support plan and will agree who is involved. They can agree the health and wellbeing outcomes they want to achieve, and they get an upfront indication of how much money they have available. They also have the option to manage the money in the following ways:
- as a direct payment (money is paid to the person or their representative),
- a notional budget (money is held by the NHS),
- a third-party budget (money is paid to an organisation which holds the money on the person’s behalf)
- or a mix of the above options.
The largest difference is that the person with a PHB will be able to use the money to meet their needs in ways and at times that make sense to them, as agreed in their personalised care and support plan.
The role PHBs play in providing personalised care
Personal Health Budgets are part of the delivery commitments included in the NHS Long Term Plan and outlined in the Universal Personalised Care Plan (UPC). The NHS Long Term Plan has committed to giving people more control over their own health and more personalised care when they need it. To deliver on this commitment, NHS England is planning to deliver 200,000 Personal Health Budgets by 2023/24. The Universal Personal Care Plan sets out how the comprehensive model will be put into practice. There are six components of personalised care, including Personal Health Budgets, personalised care and support planning, shared decision making, social prescribing and community-based support, supported self-management, and enabling choice, including legal rights to choice.
How does a PHB work?
To find out more about how Personal Health Budgets work, watch this short video.
What restrictions are there for PHB funds to be spent on?
Anything agreed in a personalised care and support plan which will meet health and wellbeing outcomes, which could include complementary therapies, equipment, personal care, supportive technology such as computers or iPads. Services should be appropriate for the NHS to provide.
Personal Health Budget funds cannot be spent on funds that are already available through primary care, including GP services, medication, prescription charges, vaccination/immunisation. PHB Funds also cannot be spent on secondary care or emergency services such as surgical procedures, screening, diagnostics, acute unplanned care (including A&E). And finally, PHB funds cannot be spent on gambling, debt repayment, alcohol, tobacco or illegal activities.
A patient’s perspective
Watch this short video about a patient ‘s experience as part of the Personal Health Budgets pilot.
What part can CNHC registrants play?
Personal Health Budgets allow patients to have more control over their health and care, and PHB funds can be used to cover costs for complementary therapies. If you think a client may qualify for a PHB, you can recommend that they speak to their local council and GP. You can also try to engage with local Health Brokers, so they understand your services and can signpost accordingly.
While access to PHBs are currently limited to certain users, the rollout of PHBs are a positive step forward for personalised care - but much progress is still to be made and will be unfolding in the next few years.