Personal health budgets for continuing healthcare
Personal Health Budgets (PHBs) have been available for people with Continuing Healthcare needs in Lancashire since April 2014. Since October 2014 those in receipt of Continuing Healthcare have had a “right to have” a PHB.
NHS England would now like CCGs to expand the “offer” of PHBs to other people with ongoing health needs. As well as those adults and children with Continuing Healthcare needs, during 2016-17 Lancashire CCGs will also be offering PHBs to the following patient groups:
- Adults and Children who do not qualify for NHS Continuing Healthcare, but who have been assessed as eligible for a package of care jointly funded by health and social care.
- Adults with learning disabilities and/or autism eligible for a jointly funded health and social care package (excluding those clients who are already in any pooled fund arrangements, where the NHS contribution to your care is held together with the social services contribution).
- Children and young adults with Education, Health and Care Plans including those in transition between children and adult services.
- Adults with complex health and social care needs, who are eligible for jointly funded packages of care.
Each request will be considered on a case by case basis.
PHBs offer the opportunity to work in equal partnership with the CCG about how your health and wellbeing needs can best be met, and are one way for you to have more choice and control over your healthcare and support.
You don’t have to change the healthcare and support that is working well for you, but if there’s something that isn’t working, or maybe help delivered in a different way is needed, you can change that.
To decide whether a PHB could be best for you, download the leaflet for more information. You can also talk to the NHS professionals in your continuing healthcare team. For more information about PHBs, you can access frequently asked questions here.
Personal Health Budget frequently asked questions
What is a Personal Health Budget (PHB)?
A Personal Health Budget (PHB) is an amount of money to support a person’s identified health care and wellbeing needs; planned and agreed between the person or their representative and the local NHS team.
Who is delivering PHBs for patients in Lancashire?
The NHS Midlands and Lancashire Commissioning Support Unit (MLCSU) provides support to seven clinical commissioning groups (CCG) to deliver PHBs, which include:
- Blackburn with Darwen CCG
- Chorley and South Ribble CCG
- East Lancashire CCG
- Fylde and Wyre CCG
- Greater Preston CCG
- Lancashire North CCG
- West Lancashire CCG
Must I have a PHB?
No-one has to have a PHB. People do not have to change the healthcare and support that is working well for them, but if there’s something that isn’t working, a PHB may be a better way of getting your care and support provided.
Where does the money come from?
The funding comes from your CCG and in cases where care and support is joint funded from your council. A PHB is not extra money. It is about using the available funding to meet your health and care needs in a way that suits you.
Are there different kinds of PHBs?
The budgets could work in three ways:
- Direct Payment
- Third Party PHB
- Notional PHB
What is a Direct Healthcare Payment?
This is where you, your representative or one of the approved Direct Payment support services holds the PHB funds to buy the care and support you and your local NHS team has agreed you need. For audit purposes you or your support service supplier will have to show what the money has been spent on. If you choose to use personal assistants you will be the employer and will buy and manage them yourself with support for a Direct Payment support service where required.
What is a third party PHB?
This is where a CQC registered provider (third party) holds the money for you and helps you decide what you need. After you have agreed this with your local NHS team, the provider buys the care and support you have chosen, and they become the employer.
What is a notional budget?
With a notional budget no money changes hands. You find out how much money is available and then talk to your local NHS team about the different ways to spend that money on meeting your needs. They will then arrange the agreed care and support.
What can the money be spent on?
PHBs are intended to be used for a range of services to help meet people’s goals, such as personal care and, in some cases selected equipment. People will not pay for emergency care or normal care from a family doctor from their PHB budget. People are not allowed to spend the money on gambling, debt repayment, alcohol, tobacco, or anything unlawful.
You will need to show what the PHB is going to be spent on in your Care and Support Plan which will need to be agreed by your NHS Team.
Will I be asked to show what I have spent the money on?
If you choose a Direct Payment PHB you will be required to keep basic records. Your PHB bank account will be audited. PHBs can only be used as agreed in your PHB Care and Support Plan.
The balance of the bank account will be reviewed regularly and any money that has not been allocated to your care or support, excluding the contingency funds, will be returned to the CCG (unless a prior agreement has been made with the named health professional).
Can I employ a relative?
Ordinarily, CCGs would not permit the employment of relatives particularly where they are living in the same household as you. The CCG / MLCSU will need to confirm that it is necessary to employ a relative / partner or anyone living in the same household as you, in order to satisfactorily meet your care needs for that service; or to promote the welfare of a child for who direct healthcare payments are being made. If family members close relatives and / or people living in the same household as you are to be employed, using a direct healthcare payment, the CCG / MLCSU must agree and record this in the care and support plan.
What about Personal Wheelchair Budgets?
A Personal Wheelchair Budget is a scheme offered to provide a wider choice for those needing to use a wheelchair.
The provider for NHS Chorley and South Ribble CCG is Southport and Ormskirk NHS Trust. More information can be found out by about personal wheelchair budgets can be found by clicking here.
If you want to find out more about Personal Health Budgets you may find the following resources useful:
You may also wish to contact the MLCSU Personal Health Budgets Team on 01772 214075 or at firstname.lastname@example.org