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How to embed Personal Health Budgets


What are PHBs?

(This information has been abridged from the NHSE Continuing Healthcare Delivery Model and the NHS England website NHS England » Personal health budgets in NHS Continuing Healthcare (CHC)

Personal Health Budgets enable people to have greater choice, flexibility and control over the healthcare and support they receive.

A Personal Health Budget is an amount of money to support a person's identified health and wellbeing needs, planned and agreed between the person and their local NHS team or healthcare professional. It is not new money, but a different way of spending health funding to meet a person's identified needs. Adults who are eligible for NHS Continuing Healthcare (CHC) funding have had a legal right to have a personal health budget since October 2014.

NHS England expects that unless there are exceptional circumstances, everyone living in their own home who is in receipt of NHS Continuing Healthcare funding will have a personal health budget. People who become eligible for NHS Continuing Healthcare funding under the Fast Track Pathway also have a legal right to have a personal health budget.

People may choose to receive their end of life care and support as a personal health budget, however there is no expectation from NHS England that this should be the case for everyone in receipt of Fast Track funding.

How are PHBs managed?

Personal Health Budgets can be managed in one of three ways, or a combination of these:

Notional budget: The NHS holds the money on behalf of the individual. The person knows how much their budget is and discusses with the NHS the care and support they require to meet their needs. The NHS purchases the agreed care and support.

A third party budget: An organisation independent of the individual and the NHS holds the budget and makes the arrangements for the agreed care and support. If the budget is used to employ personal assistants, it is the organisation holding the budget who is their registered employer.

A direct payment: Money is paid directly into the individual's (or their representative's) bank account and they can directly purchase the care and support required in line with the agreed personalised care and support plan.

What good looks like to people and patients – the PHB Implementation Framework:

Getting clear information:

  • I know where to go for clear, accessible and timely information and advice.
  • I feel well informed and supported to think about the choices available for my healthcare and support.
  • I can decide which money management option works best for me, with the agreement of my NHS team.

Understanding my needs:

  • I understand how my needs will be assessed.
  • I feel listened to, understood and involved in assessment that is proportionate and personal to me.
  • I have an equal voice in the assessment process and my expertise on my own health and care needs is valued.
  • I am able to involve others to support me if I want them to be included.

Working out the amount of money available:

  • I know how much money is available within my indicative budget and how it was calculated.
  • I have enough money to help me start to plan for how I will meet my assessed health and social care needs.

Developing a personalised care and support plan:

  • I am able to identify my outcomes and develop my personalised care and support plan with my care coordinator and any other people I wish to include.
  • I understand what each section of my plan is all about and what information is needed for sign-off.
  • I understand my role in making my plan happen.

Organising support for care and outcomes:

  • The same person continues to support me through the set-up process.
  • I have the knowledge and control over organising my care and support in the ways and at the times that make sense to me.
  • I understand my responsibilities for managing my Personal Health Budget.
  • I have good support available to me if I need it.

Monitoring and review:

  • I know who to contact if I have a query or concerns about my budget or personalised care and support plan.
  • I am supported to review my personalised care and support plan, to see what’s working and not working, and to make any changes needed.
  • I know that I can contact someone to arrange for an earlier review if my circumstances change.
  • I know what is expected for the review process and I am able to include the people that I would like involved.
  • I understand that review of my Personal Health Budget is different to any review to re-assess for NHS Continuing Healthcare eligibility.


How to do it

A series of e-learning modules have been launched to support the implementation and delivery of personal health budgets.

The modules are available through E-Learning for Health and cover the following topics:

  • An introduction to personal health budgets
  • Budget setting
  • Managing risk and decision making
  • Reviewing personal health budgets

The Personal Health Budgets programme is also available to NHS healthcare staff via the Electronic Staff Record (ESR). Accessing this e-Learning via ESR means that your completions will transfer with you throughout your NHS career.

Training, development and best practice resources: