Personal health budgets – local offer for 2016/17

This page contains some useful information on personal health budgets – including what they are, who can have one, how people can apply for one and links to other websites and information sources. This is called the ‘local offer’ for personal health budgets.

This page also explains how South Tyneside Clinical Commissioning Group (CCG) is planning to extend its local offer for personal health budgets to others in the future.

Introduction

The NHS does a fantastic job of caring for people. The skill and dedication of our staff makes the NHS one of the most admired healthcare systems in the world. However, individuals are also experts in their own health and care, and sometimes wish to gain more choice and control over the support they receive, so that it fits better with their daily lives.

To enable people to exercise more direct control, great strides are being made to personalise NHS services. Personalising care really just means working with individuals to understand what is important in their lives, only then to look to arrange care and support around this. One way in which people can do this is by taking up a personal health budget.

Personal health budgets

Put simply, a personal health budget is an amount of money used to meet an individual’s health and wellbeing needs. Following the evaluation of the personal health budget pilot programme, all CCGs are now able to offer personal health budgets, including direct payments for health care.

Personal health budgets can be used to pay for a wide range of items and services, including therapies, personal care and equipment. When deciding how to spend the budget, together with professionals involved in the care, people are encouraged to be as creative as they like. However, there are some things the money cannot be used to pay for, including:

  • Urgent or emergency treatment services
  • Surgical procedures
  • NHS charges (e.g. prescription, optical or dental charges)
  • Alcohol or tobacco
  • Gambling
  • Debt repayment
  • Anything illegal or unlawful

To ensure that everyone who wishes to take up a personal health budget is encouraged and supported to do so, there are three ways of managing a personal health budget, depending on the level of control people are willing and able to exercise over their own care and support:

  • Notional budget – individuals are advised of the amount of money which would have been spent on traditional services, to meet their needs. They discuss with professionals involved in their care alternative ways to meet their needs based on the same budget. The alternative is then proposed to the CCG. If approved, the professional arranges the care and support for the person. No money changes hands.
  • Third party budget – the money is paid to an organisation that is independent of both the individual and the NHS, which manages the budget on the person’s behalf. The organisation then arranges the support by purchasing services in line with the agreed care plan.
  • Direct payment (for health care) – a direct payment is a monetary payment to a person (or their representative or nominee) funded by the NHS to allow them to purchase the services agreed in the care plan. They are essentially money in lieu of services.

Who can have a personal health budget in South Tyneside?

Following the success of the pilot programme, the NHS rolled out personal health budgets nationally in October 2014, to people receiving NHS Continuing Healthcare and parents of children eligible for Children and Young People’s Continuing Care – who have the ‘right to have’ a personal health budget, including a direct payment. Across South Tyneside, people are advised of their ‘right to have’ a personal health budget.

During 2016/17, South Tyneside CCG is extending its offer of personal health budgets to the following groups:

  • Adults eligible for NHS Continuing Healthcare
  • Parents/carers of children and young people eligible for Children and Young People’s Continuing Care
  • Children with special educational needs and disabilities, as part of their Education, Health and Care (EHC) Plan
  • Adults and children with learning disabilities and/or autism who have complex needs.

As there is no new money coming from central Government to help deliver on this expansion, personal health budgets are expected to be managed using existing financial resources, much of which are tied up in large block contracts which will take time to unpick.

Also, as personal health budgets are relatively new to the NHS, not all professionals currently involved in a person’s care will have detailed knowledge about how they work and how people can benefit from one. This should not discourage either party to find out more information and work together to explore whether a personal health budget would be suitable.

Although South Tyneside CCG will need to take a cautious approach to further rollout, we are committed to exploring throughout 2016/17 whether these additional groups could benefit from the flexibility of a personal health budget:

  • people receiving aftercare services under Section 117 of the Mental Health Act 1983
  • people who have high levels of need but are not eligible for NHS Continuing Healthcare, but have both health and social care needs which would be suitable.

South Tyneside CCG is on a journey to offer personal health budgets to more people who could benefit and will be looking to hear the views of patients and the wider community in the process.

Key points about personal health budgets

  • NHS values still hold – no one will be expected to pay for their own care and support using their own money
  • Having a personal health budget does not entitle people to more, they are about offering choice to people using the same resources anyone else would expect to receive. CCGs have a responsibility to both patients and taxpayers that public money is used fairly
  • No one will have to get their services through a PHB if they do not want to
  • Personal health budgets will not affect any other benefits you are receiving
  • Not everyone will want to take up a personal health budget, but for those who do, help and support will be available to guide them through the process
  • There is no “new” money to fund personal health budgets. Funds will have to be directed from other existing NHS services, but this will have to be managed very carefully to avoid destabilising current services. 

Further information

Below are some other links where you can find more helpful information on personal health budgets:

http://www.nhs.uk/choiceintheNHS/Yourchoices/personal-health-budgets/Pages/about-personal-health-budgets.aspx This link will take you to the NHS Choices website, where you can find lots of information about personal health budgets, including real stories from people who took part in the personal health budget pilot programme.

www.peoplehub.org.uk This link will take you to peoplehub, a national organisation founded and run by and for people with personal health budgets. You can access various resources and toolkits on personal health budgets.

http://www.nhs.uk/chq/Pages/2392.aspx?CategoryID=68  This link will take you to the NHS Choices website, where you can find more information about NHS Continuing Healthcare.