Personal health budget policy
This policy sets out the offer for people in South West London who can receive a personal health budget in line with national legislation and guidance.
Personalisation of NHS care
Personal health budgets support the vision of a more personalised, patient-focussed NHS, and offer additional opportunities for individuals and health care professionals to work in partnership, making shared decisions and actively co-designing services and support based around what matters to people.
What is a personal health budget?
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 their local NHS Integrated Care Board (ICB) or NHS team.
It isn’t new money, but a different way of spending existing NHS funding to meet the needs of an individual. At the centre of a personal health budget is a personalised care and support plan that sets out how the agreed health and wellbeing needs of the individual will be met.
A personal health budget can allow an individual to manage and purchase services, support, activities and some types of equipment to achieve their health and well-being outcomes agreed with their local ICB or NHS team.
It works in a similar way to personal budgets, which allow people to manage and pay for their social care needs.
There are some restrictions in how the budget can be spent and having a personal health budget does not entitle someone to additional or more expensive care, or preferential access to NHS services.
A personal health budget can only be spent on things that will enable the eligible individual to be able to meet their health and wellbeing outcomes that have been agreed with the NHS.
Three ways the money can be managed
- Direct payment: The money is paid to the person or their representative and they purchase the care and support that has been agreed. This can also be managed by a direct payment support service, sometimes known as a managed account.
- Third party budget: The money is paid to an organisation who is contractually and financially responsible for all elements of the budget, including the employment of personal assistants (PAs).
- Notional budget: The money is held by the NHS, which purchases the care and support in the usual way.
There may be times when the ICB considers that a personal health budget would not be appropriate, or the use of a particular type of personal health budget would not be appropriate.
For example, where it is an impracticable or inappropriate way of securing NHS care for an individual. This could be due to the specialised clinical care required or because the personal health budget would not represent value for money. The ICB will consider how else a person’s care and support could be personalised.
Who can have a personal health budget?
The right to have a personal health budget applies to people who are:
- adults receiving NHS continuing healthcare (NHS-funded long-term health and personal care provided outside hospital)
- children in receipt of continuing care
- people who meet the eligibility criteria of their local NHS wheelchair service, these people will be eligible for a personal wheelchair budget.
- people who are eligible for after-care services under section 117 after-care of the Mental Health Act