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Personal health budgets

Managing your personal health budget

A personal health budget can be managed in three ways or a combination of them. This section will explain the options available to you.

1. Notional budget

No money changes hands. You find out how much money is available and together with your NHS team you decide on how to spend that money. They will then arrange the agreed care and support.

2. Real budget held by a third party

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 care plan.

3. Direct payment for healthcare

You get the cash to buy the care and support you and your NHS team decide you need. You have to show what you have spent it on, but you, or your representative, buy and manage services yourself.

Find out more about the direct payment regulation (PDF, 665Kb).

Monitoring and review

Once you have a personal health budget, your NHS team will periodically review your plan with you. You can also review and update your plan with your NHS team if it's necessary because your health needs have changed or you feel the current plan isn't working for you.

You can give up your personal health budget at any point if you wish to.


What happens if I underspend, or overspend, my budget?

Proper planning together with your NHS team should mean that you don’t underspend or overspend your personal health budget.

If you do underspend, your NHS team will discuss with you what happens to the money. It may be kept for your future healthcare and support, or returned to the Clinical Commissioning Group (CCG) for other budget holders.

If you spend more than planned, contact your NHS team as soon as possible and discuss this with them. No-one with a personal health budget will be denied healthcare.

What happens if I have to go into hospital?

The discussion around your plan should include arrangements for what to do if you need to go to hospital, planned or unplanned.

Can family members living in the same household be paid to provide care via a direct payment?

If you have a relative living in your household and you wish to use your direct payment to pay that relative to provide your care then you need to seek approval from your local Clinical Commissioning Group (CCG) first. Your CCG will base their decision on whether the arrangement is ‘necessary to satisfactorily meet your needs’.

For children and families in receipt of direct payments the CCG needs to establish that the arrangement is beneficial to the welfare of the child.

Contact your local CCG to discuss your options. 

Find more details about this regulation in chapter 7.3 in the Guidance on direct payments for healthcare: understanding the regulations (PDF, 665Kb).

What happens if something in my plan isn’t working for me, or my needs change?

You can review and update your plan with your local NHS team when you need to, for example if your health changes or something in your plan isn’t working for you.

In an emergency, you will get NHS care as normal. And if having a personal health budget does not work for you, your local NHS will provide the care you need as it does normally.

Will I be responsible for my own care?

You will not be left to take care of everything. You and your family and carers or representative will need to agree a plan with your local NHS team. Your plan sets out your health and wellbeing goals, and how your budget will be spent to enable you to reach them and keep healthy and safe. Your local NHS team can give you advice about planning if you want it, and will give you an indication of your budget and explain the basis on which your plan gets signed off.

You can manage the care and support you choose in different ways, ranging from doing this yourself through to getting help from another person or organisation to implement what’s in your plan on your behalf.

A care co-ordinator will have been identified in the planning process. They will be your first point of contact should you have any concerns.

Page last reviewed: 26/01/2015

Next review due: 26/01/2017

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