Personal Health Budgets – what are they and who can access them?

A Personal Health Budget (PHB) is an award by the NHS of an amount of money that allows a patient to have greater “choice and control” over planning their own care to help meet their individual health and well-being needs.

To be eligible to apply for a PHB, an individual must have a long-term health condition and disability. PHBs aim to allow a patient to receive personalised services as opposed to commissioned services that have been chosen, governed, managed and delivered by their local Clinical Commissioning Group (CCG). Eligible patients must have a care and support plan, a document that identifies the health and wellbeing needs/goals. The plan should also detail how the PHB will be spent (e.g. what, why, when, where, who) to enable the patient to achieve their individualised health and well-being needs/goals.

Since 2014, children, young people and adults who are eligible for NHS Continuing Health Care (CHC) have had the right to have a PHB. If a patient is not in receipt of CHC but is interested in a PHB, then they can express interest by contacting a health professional and/or the CCG, who will arrange a meeting to discuss the request. Children with special educational needs and disabilities (SEND) as part of their Educational Health and Care (EHC), and children with complex health needs and long-term conditions also have the right to request a PHB.

The Department of Health and Social Care has issued ‘A Consultation on Extending Legal Rights to have for personal health budgets and Integrated Personal Budgets’. The purpose of this consultation is to see if specific groups of patients who are currently not eligible to apply for a PHB could benefit from having the rights to a PHB. For example:

• those receiving Mental Health Act s117 aftercare services,
• people with learning disabilities and/or autism, 
• people who have on-going social care needs who regularly use NHS services such as physiotherapy.

The consultation process opened on 6 April and is scheduled to close on 8 June 2018. Hopefully the Government will then publish a response later in the year.

Some PHBs provisos

PHBs can be spent on any care or services that are set out in the patient’s personalised care and support plan. So, as an example, PHBs cannot be used to purchase alcohol, tobacco, gambling, repay debt or anything that is illegal. Furthermore, PHBs cannot be used to buy emergency care services, for example, if the PHB holder was to have an accident, the expectation is that they go to A&E. PHBs cannot be used to buy primary care services such as seeing a GP or dental treatment. However, other services that have been recommended by a GP such as physiotherapy or chiropody can be purchased using a PHB.

For more information

If you have any questions on the issues raised in this article, please get in touch with Nsiem Akhtar.

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