Personal Health Budgets

This page tells you about Personal Health Budgets. You may also find the information you need on the Continuing Healthcare page.

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.

Who can have a personal health budget?

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.

How does a personal health budget work?

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.

Who do I contact for more information about personal health budgets?

In the case of NHS Continuing Healthcare for Adults

If you want to know more or have any questions about Personal Health Budgets, please take a look at the Frequently Asked Questions (see below) or, you can email the team. If you do not have access to email, please contact us on 0300 561 1421 or 0300 561 1347.

Contact the CHC PHB team

The process for obtaining a Personal Health Budget

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.

Step 1: Making contact and getting clear information

How do I make contact and get clear information about Personal Health Budgets?

Please contact the Surrey Continuing Healthcare (CHC) Team in the first instance. If you do not have access to email, please contact us on 0300 561 1421 or 0300 561 1347.

Step 2: Understand health and wellbeing needs

How will my health and wellbeing needs be captured?

Your Case Coordinator will use your CHC assessment and other care records to form a picture of your care needs - for example, the frequency, duration and level of skill required to deliver your care.

Step 3: Working out the amount of money available

How will your budget be calculated?

Everyone’s needs and situations are different and therefore everyone’s personal health budget calculation is different. The amount of money available to you will be based on the amount of money that CHC would usually pay to provide care based on your assessed clinical needs.

Your budget is calculated in two steps. The first step is to calculate an Indicative Budget which will be shared with you early in the process, it is not exact or guaranteed; it is a guide as to how much money will be available to meet your health and wellbeing needs.

The second step is to complete your comprehensive Care Support Plan and the Final Budget, which will go to the PHB panel for approval. This will then be shared with you. The Final Budget calculation may be higher or lower than the original ‘Indicative’ Budget.

You will be closely involved at every step of the development of the Care Support Plan.

Step 4: Developing a personalised Care Support Plan

How is the personalised Care Support Plan developed?

The Care Support Plan is based on the foundation of your assessed care needs and indicative budget. You will be invited to give your input through the submission of a Care Support Plan document that you should fill in based on your own experience and wishes for your future care.

The next stage is to meet with your CHC Case Coordinator to discuss your comprehensive Care Support Plan. You will work with your Case Coordinator to document your assessed health needs and the care that you will need to meet them. This meeting may take place virtually.

Your Care Support Plan is an agreement between you and CHC about how you will use your personal health budget to meet your agreed health and wellbeing outcomes (goals).

You will work with your Case Coordinator to agree your health and wellbeing outcomes (the health and wellbeing goals that are most important to you), and to put plans in place to manage risks associated with arranging your own care.

You can choose to create your Care Support Plan:

  • on your own (we would recommend talking your plan through with one or more people who know you well),
  • with help from your CHC Case Coordinator,
  • or you can choose to work with an independent care planning service. If you would like to work with an independent care planning service, please let your Case Coordinator know and they will provide you with names of organisations who can help. Your Case Coordinator will then refer you to your preferred service directly. There will be no charge to you for this independent service.

We have a template available to help you create your Care Support Plan, which we can send to you.

Step 5: Organising support for care and outcomes

How will I organise support for my care and outcomes?

If you think you may need help to organise support for your care, you can ask for a supported managed account and be referred to a provider who will help you to make the arrangements you need to act as an employer of a carer/care team.

Step 6: Monitoring and review

What monitoring and review process can I expect when I have a personal health budget?

The standard three month and twelve month review process, following the National Framework for Continuing Healthcare.

Frequently Asked Questions

What can I spend my personal health budget on?

Your personal health budget can be used to buy the items linked to your health and wellbeing outcomes and that have been agreed in your Care Support Plan.

Some examples of what can be purchased are:

  • Employing Personal Assistants (PAs)
  • Hiring agency care staff
  • Social wellbeing budget of £25 per week (see more information on page 7)
  • Respite care.

Please be advised that this list is not extensive and can be discussed further with your case coordinator.

What can’t you spend your personal health budget on?

  • Anything illegal
  • Gambling
  • Debt repayment
  • Tobacco
  • Alcohol
  • Anything not directly linked to the agreed health and wellbeing outcomes in your Care Support Plan or agreed with your CHC Team.

You can find more information on national guidance on the website.

What happens if I disagree with the amount I’m offered?

Your indicative budget will be shared with you towards the beginning of the care planning process.  During the care planning process, you will be working closely with CHC. Funding agreed must be sufficient to provide for your assessed needs. These discussions are detailed, and you will be involved at every stage and your final Care Support Plan will be reached by agreement. If you do not agree with your proposed final budget, you may appeal the decision by emailing

What happens if my budget runs out?

Your personal health budget should be enough to meet your needs in the way that has been agreed. It is your responsibility to manage your budget. The budget is set on the amount of care and support you need and if you stick to this (and your needs don’t change) you should be ok. We provide one week of contingency funding in case of emergencies (for example, if your informal carer is unable to look after you for a period of time and you need to employ additional help). This contingency does not form part of your personal health budget itself, and the expectation is that it will be returned if it has not been needed. It is there to provide you with a financial support should you need it quickly. It is important that you let CHC know when you use your contingency fund.

If you have concerns that your budget isn’t going to be enough to pay for a change in care needs, please make your CHC team aware as soon as possible by emailing

Your team will work with you on any necessary revisions to your Care Support Plan or budget. 

What happens if I overspend my budget if I am receiving a direct payment?

Don’t worry if you accidentally overspend, or have a need to overspend, as long as you let us know the reason why (for example, you need extra care if your health suddenly deteriorates) or you make a genuine mistake. Just let us know as soon as possible and we’ll work through it together. 

We will audit your PHB every 3 months with the help of Surrey Independent Living Charity (if applicable) and if, at the end of a three-month period, you have overspent your budget, we will work with you to understand why.

If you deliberately misuse your personal health budget, the Integrated Care Board may stop your direct payment and instead commission your care directly.

What happens if I underspend my budget?

If you underspend on your PHB, we will work with you to understand why, to ensure that your health and wellbeing needs are being met.

In the circumstance where funds have accumulated in a PHB holder’s account beyond the monthly value, plus contingency, CHC will inform you before activating a payment break, which will remain in place until your account is returned to the acceptable balance.

What happens if I go into hospital?

Your hospital care will not be paid for out of your personal health budget as it is a service that you would normally receive i.e. you will receive emergency NHS care as normal. You must let your Case Coordinator know if you have to go into hospital for any length of time. This is because you may need your personal assistants to help you in hospital, and this will need to be agreed with your case coordinator.

Depending on the length of your hospital stay, your case coordinator may arrange to suspend PHB services that you are not using while you are in hospital.

During the development of your Care Support Plan, you will discuss with your case coordinator the arrangements for your staff if you are admitted to hospital. You will also discuss a plan for care arrangements for the period directly after discharge from hospital.

Through the normal budget reconciliation process, any money you haven’t spent as a result from your stay in hospital will be discussed and the unused funds will need to be credited to the NHS.

Can I employ my wife, husband, son, daughter or other family member who lives in the same household as me?

You can’t normally use your personal health budget to make direct payments to close family members (see below for a definition of a close family member) or anyone living in the same house. However, you may be able to do so if CHC is satisfied that a service from that person is necessary to meet the needs of the person receiving care, or to promote the welfare of a child for whom direct payments are being made.  CHC will make these decisions on a case-by-case basis.

  • Who is a close family member? - A person’s close family members are described in the regulations as:
    • the spouse or civil partner of the person receiving care;
    • someone who lives with the person as if their spouse or civil partner;
    • their parent or parent-in-law;
    • their son or daughter;
    • son- in- law or daughter- in- law;
    • stepson or stepdaughter;
    • brother or sister;
    • aunt or uncle;
    • grandparent; or
    • the spouse or civil partners of (c)- (i), or someone who lives with them as if their spouse or civil partner.

These restrictions are not intended to prevent people from using their direct payments to employ a live-in personal assistant, provided that person is not someone who would usually be excluded by the regulations. The restriction applies where the relationship between the two people is primarily personal rather than contractual, for example if the people concerned would be living together in any case.

Can I take my agency carer with me if I decide to have a personal health budget?

If you already have a carer who works for a care agency and you wish to continue to contract them, you can discuss this with your case coordinator.

What happens if my plan isn’t working for me or my needs change?

Your plan should be a living document and will change as your needs change. If you feel that your plan isn’t working for you as well as you’d like, or your needs change, please let your CHC Case Coordinator know as soon as possible, and they will discuss how your budget and plan may be changed to meet your assessed needs and agreed health and wellbeing outcomes.

Can I have a personal health budget and a personal budget?

If you are moving from a Social Services personal budget to a CHC personal health budget, then, in most cases, the Surrey CHC Team will fund ALL your health and wellbeing needs. In some cases, a jointly funded package of care may be agreed and in this case, you may receive funds into your account from both Social Services and CHC.

Do I have to have a personal health budget?

Not at all. A personal health budget may not be the best option for everyone and it’s up to you whether you choose to have one or not.  If you do choose to have a personal health budget, you can also choose to swap back to receiving CHC funding in the usual way at any time if you feel that the personal health budget isn’t working for you.  Please let CHC know if you’d like to change anything.  If you wish to employ your own personal assistant(s), you will need to have a personal health budget (either as a direct payment or as a third party budget if you would prefer not to directly employ and manage the PA yourself).

How long will it take to put a personal health budget in place?

We aim to help you get your personal health budget in place within 6 to 10 weeks. We will ensure that interim care is in place during this time if necessary. We will, however, work with you at a pace that suits you and provide as much or as little support as you need to create your Care Support Plan. 

How is the personal health budget set up?

Our standard approach is to offer a supported managed account (SMA) to all prospective PHB holders in the first instance. This is to help with the set-up, which can be quite complicated given the statutory requirements to act as an employer. Thereafter, and in discussion with your case coordinator, there will be the option to move to a different type of PHB.

However, we understand that some PHB holders will already have a direct payment set up with Social Services and therefore we will work with you to support a seamless transfer.

Can I revert back from a personal health budget?

If you do choose to have a personal health budget, you can choose to swap back to the option whereby Surrey CHC arranges your care directly at any time if you feel that the personal health budget isn’t working for you. You may also choose to keep your personal health budget but try different way of managing the money.  If you wish to employ your own personal assistant(s), you will need to have a personal health budget (either as a direct payment or as a SMA if you would prefer not to directly manage the funds yourself).

Does my personal health budget fund my equipment?

The Personal Health Budget will not be used to fund equipment. Any request for equipment will be considered through the standard CHC Equipment Panel process.

Can I have a product list and how much do services cost?

We will not produce a list of all services available that you will be able to spend your personal health budget on as it will be difficult to provide a comprehensive list. Different products and services will be appropriate for different people according to their individual needs. However, through the care planning process, we (or your chosen care planner) will be able to provide help and advice about the services that are available to you and their costs. 

The CHC team has agreements in place with some providers, and where you choose to use those providers, it may be more cost-efficient for you for the CHC team to purchase those services on your behalf.  You can also ask for help to find services from several organisations who offer ‘support brokerage’ services (please ask your case co-ordinator for a list of these organisations and a referral if you would like their help), and you can find lots of useful information on Surrey Information Point from Surrey County Council.

If I have a personal health budget, will I be responsible for my own care?

You will not be left to take care of everything. You and your family and carers will need to agree a Care Support Plan with the CHC case co-ordinator and/or care planner supporting you. A Care Support Plan sets out your health and well-being goals (outcomes), and how the personal health budget will work to help you reach them and keep you healthy and safe.

You can review and update your Care Support Plan with your Case Coordinator when you need to, for example, if your health changes or something in your plan is not working for you.

You will continue to receive other NHS services (for example district nursing, GP services) as you usually do.

Who is eligible for respite?

Patients who are living in their own home are eligible for respite, that includes PHB holders. 

What is the social wellbeing payment?

This is a small allowance for the personal health budget holder to get out and about, to visit a friend, buy a cinema ticket, spend on a hobby, or pay for subscriptions. It is for anything that enhances the PHB holders' social wellbeing. This is a £25 per week allowance and will be added to the individual’s budget and should be reflected in your reconciliation. Please discuss your preference with your Case Coordinator during your care planning.

The social wellbeing payment is for the individual named on the Care Support Plan and in receipt of services and funds. It is not for their representative, family member or carer.

How to be a good boss – what will be expected from me?

When setting up the PHB, the PHB holder will be able to access the support from the Supported Management Account provider, to find out how to set themselves up as an employer, including statutory responsibilities and how to employ staff.

Will I still receive GP and district nursing services?

You will continue to receive GP and district nursing services as normal and they will not be funded from your personal health budget.

Does NHS continuing healthcare have any effect on benefits?

If you receive Attendance Allowance (AA) or Disability Living Allowance (DLA), and you are awarded NHS CHC in a care home, your benefits may be affected. If you can be described as receiving medical treatment like an inpatient in a hospital or similar institution, then your benefit will stop on the 29th day after the NHS begins to fund their care, or sooner if you have recently been in hospital.

If your care isn’t provided by qualified nursing or medical staff and you can't be described as being like an inpatient in a hospital or similar institution, then your DLA should not automatically stop.

However, if you are getting DLA and have a Motability agreement, the higher rate of their DLA mobility component will continue to be paid to Motability’s service providers.

If you get AA or DLA, and also get a means-tested benefit such as Income Support or Pension Credit, your means-tested benefit may include an extra amount called a disability premium, or severe disability premium. If your AA or DLA stops, you’ll no longer get any disability-related premiums. This could mean you’ll get less means-tested benefit, or that you no longer qualify for any.

People getting AA or DLA who go into a care home or hospital that is funded by NHS CHC must notify the Attendance Allowance Unit or Disability Living Allowance Unit by calling 08457 123 456.

If you receive NHS CHC in your own home, you will still be able to claim AA or DLA as long as you meet the eligibility criteria for these benefits.

How will my information be protected?

Your information will be protected as it usually is by the CHC team.  You can find out more about our how we use your information on our website.

Where can I find out more?

If you want to know more, or have any questions about personal health budgets, you can call and speak to a member of Surrey’s Continuing Healthcare Team on 0300 561 1421 or 0300 561 1347.

For Children or Young Person’s Personal Health Budget

Telephone 0300 561 155

Email Surrey Children's CHC team

Surrey Independent Living Charity

Telephone 01483 458 111