Personal Health Budgets

There are three different types of budgets that can be used to meet your health and / or social care needs: personal budgets; integrated personal budget and a personal health budget. All of them follow a needs assessment and developing a care and support plan, which is personalised to you.

A personal health budget is an amount of money to support a person’s health and wellbeing needs, which is planned and agreed between the person (or someone who represents them), the CCG and / or the NHS team. A personal health budget is for your NHS healthcare and support needs and is wholly funded by the NHS.

People often refer to personal health budgets as a direct payment. However, a direct payment is one way of managing a personal health budget. It’s when you get the money directly to buy the agreed care and support you need rather than the NHS arranging it for you.

An integrated personal budget is used to meet both your healthcare and social care needs. It is the amount of money both your local council and the CCG pay towards any support you need. An integrated personal budget aims provide a seamless approach to care, so that people and their families have the same experience of care and support, regardless of whether their care is funded by the local authority or the NHS and it is joined up. The person has an integrated care and support plan to identify their health, wellbeing and social care outcome and the amount of money to support their health and social care needs are joined up.

A personal budget is funded by your local council to your social care and support needs. It is the amount of money your local council will pay towards any social care and support you need.

If you think you, or someone you know, needs help to cope day to day, the first step is to get information and advice by looking on https://www.nottshelpyourself.org.uk or by contacting your Council by calling them or online; all the contact details for Nottinghamshire County Council and Nottingham City Council can be found at: https://www.nottinghamshire.gov.uk/ or https://www.nottinghamshire.gov.uk/

The underlying principles of a budget are that an individual will:

• Be able to choose the health and social care outcomes they want to achieve (in agreement with health/social care professionals)
• Know how much money they have for their care and support
• Be enabled to create their own care and support plan
• Be able to spend the money in ways and at times that make sense to them (as agreed in their care and support plan)
• Be able to choose how their budget is held and managed

The CCG must follow the National Guidance from NHS England to determine who can have a personal health budget; as outlined in the next section.

The CCG and Local Authority follow National Guidance and join up locally to support people to have integrated personal budgets.

• Adults receiving NHS continuing healthcare NHS continuing healthcare (NHS-funded long-term health and personal care outside hospital)
• Children and young people receiving NHS continuing healthcare
• People who meet the eligibility criteria of the wheelchair service can have a personal wheelchair budget
• Carers to support them to have a break from their caring role and meet their health and wellbeing needs.

• People with mental health problems and are entitled to S117 aftercare Mental health aftercare if you have been sectioned – NHS (www.nhs.uk)
• People who have a package of care funded by health and social care. The eligibility for the CCG to fund a joint package of care is outlined in The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care

An essential step in the personal health budget process is developing a care and support plan. It starts with a different conversation based on “What matters to you?” rather than what is wrong with you?

• It includes a description of the person, what matters to them and all the necessary elements to make the plan achievable, including actions, outcomes and goals
• Captures and records conversations, decisions and agreed outcomes in a way that makes sense to the person
• Is proportionate, flexible and adapted to a person’s health condition, situation and needs

• Is empowered and builds knowledge, skills and confidence
• Feels confident that the process and the plan will deliver what matters most to them
• Is at the centre and will agree who is involved
• Is seen as a the expert of their own life, including skills, strengths, experience and relationships
• Is valued as an active participant in conversations and decisions
• During planning, the person:Feels prepared, knows what to expect and is ready to engage
• Can access clear and timely information and advice
• Has time and support to develop their plan in a safe and reflective space
• Is listened to and understood, building trusting and effective relationships with key people
• Is able to agree their health and wellbeing outcomes with the relevant health, education and social care professionals
• Can formally and informally review their personalised care and support plan

Everyone with a personal health or integrated personal budget will be offered support to think through how they would like to use their budget to meet their health and wellbeing needs.

A budget can be spent on care or support to meet the persons outcomes set out in the care and support plan. This is put together with the individual and the NHS team or social care team. Every care and support plan will need to be agreed by the CCG and/or social care. All care and support plans and budgets must be lawful, appropriate, and effective and demonstrate value for money.

Things that it would not be right for the NHS/Government to fund:

• Alcohol, tobacco, gambling or debt repayment, or anything that is illegal.

Also the plan cannot be used to purchase any emergency, primary and other universal care services.

A personal health budget can be managed in 3 ways, or a combination of these.

1. Notional budget: No money changes hands. You find out how much money is available for your assessed needs and together with your NHS team you decide how to spend that money. They will then arrange the agreed care and support plan.
2. Third party budget: An organisation legally independent of both of you and the NHS holds the money for you, and also pays for and arranges the care and support agreed in your care and support plan.
3. Direct payment: You get the money to buy the care and support you and your NHS team agree you need. You must show what you have spent it on, but you, or your representative, buy and manage services yourself.

The Nottingham and Nottingham Personal health budget can be found on the website within the Continuing Healthcare Policy COM-003-CHC-Children-and-Young-Peoples-Packages-of-Health-and-Social-Care-Policy-v1.4.pdf (kinstacdn.com)

PHB Guidance

If you think you may be eligible and would like to apply for a personal health budget or integrated personal budget, or would like more information about what is involved, the people to contact are:

The local Continuing Health care team

Locally, there are two teams who provide Continuing healthcare assessments and care and support planning depending on the GP you are registered with. If the GP is in Mansfield, Ashfield, Newark or Sherwood contact the Mid Nottinghamshire NHS CHC Team on 01623 785450.

If your GP is in Gedling, Broxtowe, Rushcliffe or Nottingham City contact the Nottingham Citycare CHC team on 0115 8834720.

Joint funded health and social care funding including S117 Aftercare

This offer follows an assessment of your needs by social care and the Continuing healthcare teams; contact details are above. You can call your Council or contact them online; the contact details can be found at https://www.nottinghamshire.gov.uk/ or https://www.nottinghamcity.gov.uk/

Wheelchair Budget Information

If you live in Mansfield, Ashfield, Newark or Sherwood contact the Mansfield Wheelchair service which is provided by the Blatchford Group NHS Wheelchair Services. The service is based at Mansfield Community Hospital and they can be contacted on 01623 785076 or email maccg.wheelchairservices@nhs.net

If you live in Gedling, Broxtowe, Rushcliffe or Nottingham City the service is provided by Nottingham University Hospitals NHS Trust. The service is based at the Mobility Centre, City Hospital campus. You can contact them on 0115 969 1169 Ext: 57581 or 57552 https://www.nuh.nhs.uk/mobility-centre/

Survivors of childhood sexual abuse

The offer of personal health budgets to survivors is facilitated by the Nottinghamshire Sexual Violence Support Services (Notts SVS) and the CCG. The service is not part of the police, NHS or any other public service. They are a Registered Independent Charity that has been supporting survivors of sexual violence for over 35 years. Contact Nottingham Sexual Support Service Tel: 0115 9470064 https://nottssvss.org.uk/

Carers NHS Funded Breaks

This offer is available to Adult carers (over 18) in Nottinghamshire and is provided by Nottinghamshire County Council, following a carer’s assessment and care and support plan. How to contact the Council can be found at https://www.nottinghamshire.gov.uk/

The CCG will be expanding the offer of personal health budgets so more people can benefit from them. If you would like the CCG to provide a personal health budget outside of groups listed, please get in touch with the CCG Personalised care team by emailing nnccg.personalisedcare@nhs.net

PHB Guidance

The CCG will be expanding the offer of personal health budgets so more people can benefit from them. If you would like the CCG to provide a personal health budget outside of groups listed, please get in touch with the CCG Personalised care team by emailing nnccg.personalisedcare@nhs.net

PHB Guidance

Nottinghamshire Carers Hub
We’re here to make life better for carers – Carers UK

My Life Choices (MLC) is a strategic co-production group established in September 2017 to work in partnership with the CCG. Members are committed, motivated people local to Nottingham and Nottinghamshire who have valuable lived experience; all members’ access health and social care services, including some with complex needs. To join or speak to the group email nnccg.personalisedcare@nhs.net