Personal Health Budgets

What is a personal health budget (PHB)?

A Personal Health Budget (PHB) is an amount of money to support your health and wellbeing needs, which is planned and agreed upon between you (or someone who represents you) and your local NHS team. It is not new money, but a different way of spending health funding to meet your care needs.

A PHB allows you to manage your healthcare and support, such as treatments, equipment and personal care, in a way that suits you. It works similarly to personal budgets, which allow people to manage and pay for their social care needs.

NHS England has produced a short video entitled what are personal health budgets? This describes what they are and how they are helping people get care and support that is right for them. You can also read more on the NHS England website.

The right to have a PHB applies to people who are:

• Adults receiving NHS Continuing Healthcare (NHS-funded long-term health and personal care provided outside hospital)
• Children receiving NHS Continuing Care.

NHS Continuing Healthcare service for Adults

When NHS Continuing Healthcare (CHC) funding has been agreed upon, you will receive a letter confirming your eligibility. If you are interested in arranging a Personal Health Budget, please contact the team and they will arrange for a CHC case coordinator to contact you.

Contact the Surrey Heartlands CHC PHB team

The case coordinator will complete an assessment to determine your health and wellbeing needs. Then, if you want to go ahead with the PHB, you and the case coordinator will develop a personalised care and support plan which meets your needs and complies with the NHS funding rules. The amount that someone receives in their PHB will depend on the assessment of their health and wellbeing needs and the cost of meeting these needs.

You can, if you choose, be supported throughout this planning process by an Independent Living Advisor from Surrey Independent Living Charity.

As soon as your care support plan has been approved, your PHB will need to be activated. This can be organised in several different ways:

1. Notional personal health budget
   • You have a say over what care you receive but no money changes hands. You do not have any responsibility for paying for the services you receive. You do not have to manage a bank account or keep invoices or receipts.
   • You will not be able to employ anyone directly to provide you with care and support; however, you can have care provided by an agency.
   • All care and support services provided to you will be purchased by the Surrey Heartlands Integrated Care Board (ICB) and managed by them on your behalf.
   • This will be implemented as soon as a suitable agency is identified.
2. Direct payments
   • A direct payment is where the ICB pays money directly to you or your chosen representative. The money will be paid into an account set up for this purpose every month. If you have received a personal budget from social care in the past, you are likely to find there are differences in the arrangements with a PHB.
   • You or your representative will buy and manage your chosen services and will be accountable for showing what the money has been spent on. It is therefore very important to record all your income and expenditure and to keep receipts, invoices and bank statements. These will need to be submitted for a monthly reconciliation.
   • If you choose to employ your own personal assistants, you or your representative will be their legal employer. 
   • Timescales with a direct payment can vary, but usually it takes up to 6 weeks to set up this type of payment. For interim support during this period a temporary supported managed account can be set up. This will need to be discussed with your case coordinator.
   • Additionally, if you require elements of support with recruitment or ongoing finance management, this is available through Surrey Independent Living Charity (SILC). If you would like funds to be fully managed, you can opt for a Supported managed account. See below for further details.
3. Supported managed account (SMA)
   • An SMA is where a local service provider named Surrey Independent Living Charity (SILC) will manage all the money for you, but you will remain the legal employer of any personal assistants you hire.
   • SILC will monitor your account and check your receipts, invoices and bank statements. You will still have control over how the budget is used.
   • SILC will prepare a statement of income and expenditure at your request so that you can see how much money is available in your PHB and how it is being spent.
4. Third-party personal health budget
   • An organisation legally independent of you and the NHS (for example, an independent user trust or a voluntary organisation) holds the money for you and acts as the legal employer, arranging the care and support agreed in your care plan. 
   • This is currently in development and not available to PHB holders at present.

Your Case Coordinator is responsible for ensuring the help and support you receive meets your needs. As your needs change, so might your PHB, to ensure it is giving you the most appropriate support.

Surrey Continuing Healthcare follows the 6-step model for Personal Health Budgets which are as follows:

1. Making contact and getting clear information
2. Understand health and wellbeing needs
3. Working out the amount of money available
4. Developing a personalised Care Support Plan
5. Organising support for care and outcomes
6. Monitoring and review

These steps are used to define our processes, details of which are given in the sections which follow.