Personal health budgets are about having greater control and choice over the care and support you receive, which can improve your health and wellbeing.
A personal health budget is one way of receiving more personalised care: knowing how much money is available to spend should enable you to choose the services, equipment or therapies which best meet your needs.
We already know that providing greater choice and control leads to better outcomes and enables people to remain independent for longer. Personal health budgets may therefore reduce the need for short-term health and wellbeing interventions, for example needing to visit a health clinic, allowing people to get on with their lives.
Personal health budgets support Birmingham and Solihull’s health and wellbeing priorities to help vulnerable people in becoming more resilient and staying independent.
Produced together with a healthcare professional, your personalised care and support plan is at the heart of making personal health budgets work well. This plan will help you identify your health and wellbeing needs and goals, and together with your local NHS team sets out how the budget will be spent in order to achieve the best results for you.
If you have a personal health budget you will be able to use it for a range of things, for example personal care, equipment or therapies. You may decide that traditional services work best for you, however, if they don’t you could also use your personal health budget for an alternative activity which helps improve your health and wellbeing.
You will not be able to pay for emergency care or care you usually get from your GP. You are also not allowed to spend the money on gambling, debt repayment, alcohol, tobacco or anything unlawful.
There are three ways you can manage your personal health budget:
Notional budget: No money changes hands. A budget is determined and, together with your NHS team, you decide on how best to spend it. They will then arrange the agreed care and support. Regular reviews will take place to ensure your personalised care and support plan is working well for you.
Third party budget: An organisation legally independent of both you and the NHS (for example, an independent user trust or a voluntary organisation) holds the money for you and pays for the care and support agreed in your personalised care and support plan.
Direct payment: The budget is transferred directly to you to buy the care and support you and your NHS team agree within your personalised care and support plan. You, or your representative, buy and manage services directly yourself. A regular review will take place to ensure that your personal health budget is meeting your needs and goals.
NHS Birmingham and Solihull offers personal health budgets in the following areas:
Continuing Healthcare: Personal health budgets have been available in Birmingham and Solihull for adults and children and young people with continuing healthcare needs since October 2014. Anyone who is eligible for continuing healthcare and receives care in their own home, will be eligible for a personal health budget.
Mental Health: Since December 2019, people who are eligible for after-care services under section 117 of the Mental Health Act have a legal right to have a personal health budget. Your care co-ordinator may ask you whether you are interested in a personal health budget and can discuss this with you if you have any questions.
End of life care: NHS Birmingham and Solihull is undertaking a pilot with a number of hospices across Birmingham and Solihull to provide choice and control for individuals with a life limiting illness. More information can be found on the end of life personal health budgets page.
Personal wheelchair budgets: All wheelchair users who have long-term postural and mobility needs are eligible for an assessment for a personal wheelchair budget (PWB) by their wheelchair service. More information can be found on the personal wheelchair budgets page.
If you are eligible for a personal health budget, together with your healthcare professional from your local NHS team, you can explore whether you believe a personal health budget is the right choice for you. Below you will find a step-by-step guide:
- Express an interest in personal health budget: you can either express an interest with your local NHS service or team, or a healthcare professional may ask whether you have considered a personal health budget before.
- Explore a personal health budget in more detail: With a healthcare professional, usually during a face-to-face visit, you can explore whether you feel a personal health budget might be right for you. Any questions about ongoing support the NHS provides, your future responsibilities and the process can be answered. You will have all the information you need to make an informed decision.
- Calculate the indicative personal health budget: If you decide a personal health budget is the route for you, together with the healthcare professional, you will outline all your health and wellbeing needs. This information is used to calculate what your indicative budget will be. This will be explained and shared with you.
- Developing the personal health budget support plan: Central to your personal health budget is your personalised care and support plan, which you develop with a healthcare professional. The plan helps you decide on your health and wellbeing goals and how your budget is best spent to achieve these.
- Getting the personal health budget plan agreed: Your personal health budget care and support plan is agreed between you and the local NHS team.
- Putting the personal health budget plan in place: Once your support plan and the budget are confirmed, your plan can be put into action. In the case of a direct payment or third-party budget the personal health budget contracts must be in place prior to any money being able to be paid. Your plan will detail which services, equipment or therapies you will need, who will support you in obtaining them and by when. You will be able to shop around to get the right services for you via our online e-marketplace, PHB Choices.
- Monitoring and review: To make sure that your personalised care and support plan is up-to-date and that the services you are using are meeting your needs and goals, a regular review will take place.
For a number of people opting to have a personal health budget, the employment of a personal assistant is a great way to help manage their care and achieve agreed health and wellbeing outcomes.
Becoming an employer can be a daunting prospect, however there is support available to help you meet your responsibilities as an employer and to ensure that all legal requirements are met.
It is a requirement that all personal assistants are contracted employees in line with HMRC guidance. This is to protect you as an employer and ensure your health and wellbeing needs are met in a safe and effective way.
If you’d like to find out more about employing a personal assistant, there are a number of information sources online.
Patient stories
Claudia, 59, has multiple sclerosis (MS). She uses a wheelchair and she has to be hoisted for all transfers because of her mobility issues.
Hoists provide a way to transfer somebody with limited mobility without putting unnecessary strain on the carer or the person being moved.
The mum-of-two, who lives with her husband and children, wanted more freedom.
Claudia said: “The more my condition deteriorated, the less freedom I had to do the things I used to enjoy, such as going shopping and seeing friends.
“I relied on my husband and two children, who are both adults, to help me, but there’s only so much they can do.
“I wanted a personal assistant to take me out once a week in my wheelchair, so I could enjoy a social life, which was missing from my routine.”
Claudia had support from a care agency, funded through her continuing healthcare budget, but she found that there was no consistency in the times that carers would arrive or familiarity with care staff.
So, Claudia and her husband requested a personal health budget (PHB) via a direct payment.
A PHB via direct payment would allow Claudia and her husband to employ their own personal assistants, to ensure consistency with carers and have more choice and control over the time carers would arrive.
Having a direct payment PHB has been very positive for Claudia.
Claudia now has the same group of carers and with their support she is able to attend MS groups and social events. Her personal assistants have also been added to her mobility insurance to drive her mobility car.
Colin, 66, lived at home with his wife and daughter when he was diagnosed with chronic obstructive pulmonary disease (COPD) and, as his condition worsened, he was determined to remain at home with his family.
The father-of-one’s health deteriorated rapidly when he developed a chest infection, and he became eligible for end of life care.
Colin was supported by a hospice care team who had access to a personal health budget (PHB), which allowed them to get funding to make sure Colin could remain at home.
Through PHB funding, Colin’s hospice care team arranged for a carer to visit him at home every day, and they also arranged for Colin to have new bedding and clothes delivered, as well as groceries, from a local community group, for his family.
Colin and his family said they could not thank healthcare staff enough for their support, which allowed Colin to remain at home.
Further information
If you feel you may benefit from a personal health budget and would like to know more, then please speak to your local NHS team and they will outline what the next steps are and support you throughout the process.
You can also visit:
Should you require the information on this page in a different format, please email communications.bsolicb@nhs.net.