Continuing Healthcare

Please find below some information relating to continuing healthcare funding:

Personal Health Budgets

From April 2016, NHS Herefordshire CCG is extending the range of people and health conditions that can access Personal Health Budgets (PHBs). This will include people who have Learning Disabilities, people who currently have their care funded by NHS Herefordshire CCG and people with life limiting long term conditions such as Multiple Sclerosis and Motor Neurone Disease.

If you:
• Are resident in Herefordshire or registered with a Herefordshire GP
• Have a Learning Disability and currently receive services or care funded by Herefordshire CCG
• Have a long term life limiting neurological condition

And would like to find out more about personal health budgets call the Continuing Healthcare Team on 01432 383822 (Duty desk).

What is a Personal Health Budget?

A personal health budget is an amount of money that is spent on meeting the healthcare and wellbeing needs of people, generally those with a long term illness or disability. The NHS wants to make it easier for people and for them to get the NHS care that best suits them. Having a personal health budget is one way to achieve this.

Clients with a personal health budget can use it for a range of things to help you meet health and wellbeing goals, for example therapies, personal care and equipment.

Personal Health Budgets are not allowed to be spent on things like gambling, debt repayment, alcohol or tobacco, or anything unlawful.

Types of Personal health Budget 

Notional budget – No money changes hands. You find out how much money is available and talk to your doctor or care manager about the different ways to spend that money on meeting your needs. They will then arrange the agreed care.

Direct payment – You get the cash to buy the services you and your doctor or care manager decide you need. You have to show what you have spent it on, but you buy and manage services yourself. A personal health budget is not the same as a direct payment.​

Real budget held by a third party – A different organisation or trust holds the money for you, helps you decide what you need and then buys the services you have chosen.

Applying for a Personal Health Budget in Herefordshire 

NHS Herefordshire Clinical Commissioning Group currently offers Personal Health Budgets to anyone receiving NHS continuing healthcare but do not need to be in hospital. For example this may be provided for people with learning disabilities as detailed above or people who are physically frail.

At the centre of your personal health budget is your care plan. This plan helps you decide your health and wellbeing goals, together with the local NHS team who support you, and set out how your budget will be spent to enable you to reach them and keep healthy and safe.

Key points:

• The NHS stands by its promise that it is there for everyone, based on need not ability to pay.
• The NHS care and support you get should be safe and effective. It should be a positive experience.
• Personal health budgets should help people who may not always get the best out of the NHS to get a better service, not make things worse.
• You will not have to get healthcare in this way if you do not want to.
• You should have as much control over decisions as you want.
• NHS and social care organisations should work in partnership with you and with each other.
• If you are not able to have a personal health budget, you can still speak to your local NHS team about how your needs can be met in another way that is more personal to you.

How is my Personal Health Budget managed?

Once your care plan has been agreed, the money in your personal health budget can be managed in a number of different ways:

Notional budget. No money changes hands. You find out how much money is available and 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.

Real budget held by a third party. A different organisation or trust holds the money for you and helps you decide what you need. After you have agreed this with your local NHS team, the organisation then buys the care and support you have chosen.

Direct payment for healthcare. You get the cash to buy the care and support you and your local 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.

Key Points:

Individuals will need a separate bank account to receive a personal health budget via a direct payment. This account must only be used for purchasing care. However, it can also be used for receiving and managing a social care budget or Independent Living Fund payments.

If you wish to have a budget but don't want to manage it yourself, it may be possible for someone else to manage the budget on your behalf. If you care for someone who does not have capacity to manage a personal health budget themselves, the same arrangement may also be possible. Every effort must be made to ask the person about their wishes and to keep their best interests in mind.

You can also 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 care plan on your behalf.

You can review and update your care 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. You can also give up your personal health budget if you prefer to.

Further Information, Support and Resources

The Continuing Healthcare Team can advise you over the telephone on 01432 383822 (duty desk).

You can talk to the person who helps most with your care and support, such as your care manager or family doctor. They can talk about personal health budgets with you.

Alternatively:

The Peoplehub website is a personal health budgets network which offers information, support and is a good place to talk with other people who have a personal health budget.

For further information visit the NHS Choices personal health budgets page and the NHS England personal health budgets page.