Personal Health Budgets Guide – including people with learning disabilities

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. The aim of personal health budgets is to enable people with long term conditions and disabilities to have greater choice, flexibility and control over the health care and support they receive.

Since April 2014 people eligible for NHS Continuing Healthcare* had the ‘right to ask’ for a personal health budget.  In October 2014 this becomes a ‘right to have’. Clinical commissioning groups (CCGs) will also be able to offer personal health budgets to others that they feel may benefit from the additional flexibility and control.

*[NHS continuing healthcare is the name given to a package of care that is arranged and funded solely by the NHS for individuals who are not in hospital but have complex ongoing healthcare needs.]

The ‘Including People with learning disabilities’ personal health budget document has been developed to give guidance on implementing personal health budgets for people with learning disabilities, including areas of specific consideration and good practice case studies.

The key messages to service managers and those involved in implementing personal health budgets are:

  • The introduction of personal health budgets offers local leaders a great opportunity to work together with disabled people, their families and local services, ensuring that systems and processes are designed to support individuals rather than individuals being ‘fitted in’: “your care, your way, your say”.
  • Guidance on NHS Continuing Healthcare and on personal health budgets emphasises a ‘can do’ approach to improving choice and control and to positive management of risks. The bar should not be set higher for personal health budget holders. The plan and budget should be about the whole person and the support they need to lead a full and active life, not just health needs or health care.
  • Best practice in support planning is for this to be separate from assessments for eligibility and for budget holders to have a choice of assistance, including organisations external to CCGs and councils (e.g. led by people with lived experience). Support planning needs to be informed by clear clinical advice. People should get the same opportunities and access to specialist support regardless of which organisation (children’s services, adult services, NHS or local government) is responsible for funding their care.
  • It is important to work across health and social care and with organisations providing care and support to ensure that a wide range of support options are available. Individual service funds (ISFs) offer a way for some people who do not want to take on direct management of their personal budget to still get increased choice and control via a chosen provider.
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