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Personal Health Budgets

What are Personal Health Budgets?

A Personal Health Budget is an amount of money to support a person’s identified health and wellbeing needs, the application of which is planned and agreed between the individual, their representative, or, in the case of children, their families or carers and the local NHS team. It is not new money, but is money that would normally have been spent by the NHS on a person’s care being spent more flexibly to meet their identified needs.

There are five key features of a personal health budget. The person with the personal health budget (or their representative):

  •  must know how much money they have for their health and care support;
  •  is enabled to choose the health and wellbeing outcomes they want to achieve in agreement with a healthcare professional;
  •  is enabled to create their own care plan, with support if they wish;
  •  is able to choose how their budget is held and managed, and can have a direct payment if they wish;
  •  is able to spend the money in ways and at times that makes sense to them, as agreed in their plan.

The budget can be provided in one of the following ways:

1. A notional budget - where Bedfordshire CCG holds the budget but utilises it to buy services on behalf of the service user.

2. A third party budget - where an organisation independent of the service user and the NHS manages the budget on the individual’s behalf, and buys the services on the user’s behalf.

3. A direct payment - where money is transferred to the service user or their representative or nominee, who buys the services directly.

For a summary of the PHB system, read the CCG's own document, A Brief Guide to Personal Health Budgets.

Eligibility

From October 2014, people who are assessed as, or are already eligible for, NHS Continuing Healthcare (CHC) and families of children eligible for Continuing Care (CC) will have a “right to have” a Personal Health Budget. Individuals and their representatives already in receipt of NHS CHC or CC may take up their right for a personal health budget at any time and Bedfordshire CCG must give due consideration to any request made.

Local Authorities also offer Personal Budgets, which may be paid as a Direct Payment to the individual, and can include services such as Social Care. A Personal Budget and Personal Health Budget may be linked, to enable the individual to have a joint package of care.

Information on Bedford Borough Council Personal Budgets and Direct Payments

Information on Central Bedfordshire Council Personal Budgets and Direct Payments

Children and Young People who have Education, Health and Care Plans also have a right to request a Personal Budget. Part of the Personal Budget may involve health services, funded via a Personal Health Budget (see Future Developments).

Bedford Borough Council: Education and Health and Care Plans (EHCP)

Central Bedfordshire Council: Education and Health and Care Plans (EHCP)

Decision Process

There may be circumstances when Bedfordshire CCG considers a personal health budget to be an impracticable or an inappropriate way of securing NHS care for an individual, for example:

  •  Will a PHB contravene any relevant legislation?
  •  Will a PHB meet the assessed needs of the individual?
  •  Does the PHB represent good value for money for the NHS?
  •  What is the wider impact of the decision on the health economy?

If an individual and/or their representative, requests a Personal Health Budget and is turned down, Bedfordshire CCG must set out in writing the reasons why the request has been refused. Once this information has been received, the person and/or their representative may request that Bedfordshire CCG reconsiders its decision. They may also provide additional information to the CCG that may be relevant to the decision. The CCG must reconsider its decision upon such a request being made.

Future Developments

As well as adults receiving continuing healthcare, and children receiving continuing care, Personal Health Budgets are being considered / developed in the following service areas:

  •  Children and Young People, aged 0 to 25 years old, with Education, Health and Care Plans are entitled to a Personal Budget. This is currently managed through the relevant Local Authority. Bedfordshire CCG are working to offer Personal Health Budgets as part of the EHC planning process. These are currently available to children with an EHC Plan who are also eligible for Continuing Care.
  •  By 1st April 2017, the Wheelchair Service Voucher Scheme will be replaced with a Personal Health Budget for Wheelchair Services.
  •  Personal Health Budgets are being considered for Mental Health patients receiving Section 117 aftercare services.
  •  Personal Health Budgets are being reviewed for adults and children with Learning Disabilities.

Further Information

For more information - including some real-life examples of the way in which patients buy their care and support through their PHBs - see the PHB section of the NHS Choices website.

Or have a look at the NHS England website or view this short video on PHBs in Continuing Healthcare.

To discuss PHBs with the Adult’s Continuing Healthcare team or the Children’s Continuing Care team:

Continuing Healthcare (CHC) Team
NHS Bedfordshire Clinical Commissioning Group
Suite 2, Capability House, Wrest Park
Silsoe
BEDFORD
MK45 4HR

Telephone: 01525 624300

Email: chcadmin@nhs.net 

Children, Young People and Maternity Team
NHS Bedfordshire Clinical Commissioning Group
Suite 1, Capability House, Wrest Park
Silsoe
BEDFORD
MK45 4HR

Telephone: 01525 624334

Email: admin.strategy@nhs.net 


 

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