A Personal Health Budget (PHB) represents the funding to meet an individual’s health and wellbeing needs - it is not ‘new’ money, but existing funding which is being used differently.

Personal health budgets can take different forms: notional budgets, third party arrangements and direct payments, as well as combinations of the three in some instances. Personal health budgets are as a result of government proposals to increase personalised care. They are not intended to reduce healthcare costs, nor do they represent any reduction in service for patients.

NCL ICB will consider a request for Personal Health Budgets for the following individuals, who have the 'right to have' a PHB: 

• An individual eligible for Continuing Care requiring a package of care at home, school or community
• An individual eligible for Continuing Healthcare requiring a package of care at home
• An individual eligible for an NHS wheelchair
• An individual eligible for s117 after care services

Other cohorts identified for development by NCL ICB or through a pilot project.

Additionally, NCL ICB will consider a request for PHB for the following individuals, who have the 'right to ask' for a PHB:

• Adults aged 18 and over with a learning disability and / or autism and / or mental health and / or behaviour that challenges living in a community setting who will benefit from having a PHB. 
• Children and young people (from birth to 25 years old) who may not be eligible for Continuing Care but have an Education, Health and Care (EHC) plan and could receive a PHB for the health element of their plan 
• An individual requiring end of life care services 
• An individual whose care is funded jointly by NHS and social care
• An individual with mental health needs. 

All personal health budgets are underpinned by a personalised care and support plan (PCSP), which is produced jointly between the client and their family/carers and a health professional. In NCL ICB, these plans will be co-produced and signed off by the relevant service and in the case of NHS Continuing Healthcare, a nurse who currently case manages that client would be involved in the process. The personalised care and support plan moves the focus of care provision to a co-produced piece of work with the client and their family rather than directed by the clinician. 

There are regulations in place which set out items that direct payments PHBs cannot be spent on (such as tobacco, gambling, alcohol, debt repayment, emergency care and core GP services). Whichever type of personal health budget is chosen, the expenditure is monitored by the responsible commissioner within NCL ICB. 

Personal Health Budgets are now the default delivery model for NHS Continuing Healthcare funded home care and any patient/client has the right to request a personalised health budget already, if they qualify for funding in any of the above-mentioned services. 

Should you have any queries, email the Personal Health Budget and Caretrack specialist via the address provided:
e: steven.deller@nhs.net