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The National Personal Health Budget Pilot Programme. Gemma Newbery ‘NHS Personal Health Budget’ Project Manager. What is a Personal Health Budget? (PHB).

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the national personal health budget pilot programme

The National Personal Health Budget Pilot Programme

Gemma Newbery

‘NHS Personal Health Budget’ Project Manager


What is a Personal Health Budget? (PHB)

A Personal Health Budget (PHB) is an amount of money that is allocated to a patient. The patient has choice and control over how this money is spent to meet their own personal and clinical outcomes.


Where have PHBs Come From?

Personal Health Budgets (PHBs) are one part of the drive to personalise public services in general, and health services in particular. They are a way to allow people to take more control over how money is spent on their healthcare.

Positive lessons from social care

Very new to the NHS

  • A firm commitment to personal health budgets
  • But begin by piloting
  • Take time to evaluate, finding out what works
  • Build on what works in other areas and link with them

Promising international evidence

Many risks and complexities

evidence of the benefits of personalisation

Who benefits


nottingham s nhs personal health budget pilot
Nottingham’s NHS Personal Health Budget Pilot

To explore the use of Personal Health Budgets for:

Patients with neurological conditions referred to the new Community Neurology Service

Patients with memory problems referred to the Intermediate Care Service at the Willows

Patients that become eligible for fully funded NHS Continuing Health Care or joint funded care packages

Carers of patients receiving a Personal Health Budget


Clear Government Support for PHBs

NHS White Paper

Spending review

Mental health strategy

October 2011 announcement that, subject to the evaluation, people receiving NHS Continuing Healthcare will have a right to ask for a personal health budget by April 2014

SEN Green Paper

Right to Control

Carers’ strategy

NHS Operating Framework.

NHS Future Forum and the Government’s response

phbs key points
PHBs: Key Points

At the heart of a personal health budget is a care plan which is developed in partnership. Bringing together the clinical knowledge and expertise of professionals in partnership with the individual’s knowledge of how their condition affects them and what works for them.

The plan and the budget enables people to meet their needs in different ways, ways that work for them. Once it has been developed, the plan will be subject to clinical governance and sign off.

Personal health budgets are not about new money; rather they use money which would have been spent on an individual’s care in different ways.

Personal health budgets aim to deliver better health and wellbeing outcomes through choice and control. They should facilitate integration across services.

5 steps
5 Steps

How much?

Support Plan

Agree the Plan

Organise Support


step 1 how much
Step 1- How Much?

Based on the cost of providing the patient with commissioned services

Continuing Health Care Resource Allocation System

step 2 support plan
Step 2 – Support Plan

Self Brokerage


Internal (NCC)


Directory of Services:

step 3 agree the plan
Step 3 - Agree the Plan

Step 1 – Clinical sign off by lead clinician

Step 2 – Commissioning sign off

step 4 organise the support
Step 4 – Organise the Support

Notional individual budget

Already legallypossible

Personal care


More direct control to individuals

Real budget held on the individual’s behalf

Direct payment – cash held by patient

step 5 review
Step 5 - Review

Review periods based on:

Patient’s condition


Clinical Agreement

Support Plan Period

patient examples mental health
Patient Examples: Mental Health

Pete’s Story – DVD

early lessons key challenges 1
Early Lessons & Key Challenges - 1

It is essential that health and social care work together to facilitate personalisation

Personal Health Budgets aren’t for everyone

People want help to develop a support plan and decide how to spend their budget

Support planning is time consuming if it is done properly

Fluctuating and changing need


The culture change to facilitate personalisation in health is huge

It is important to recognise and record risks

Market development

Delivering Personal Health Budgets in a time of financial challenge

Developing the right systems and processes

Early Lessons & Key Challenges - 2


What Next - 1?

To build on the lessons learnt throughout the PHB pilot to develop a sustainable, efficient and effective process for providing patients with a PHB in Nottingham.


What Next - 2?

  • Roll out for patients eligible for Continuing Health Care
  • Roll out for joint funded patients
  • Continue to offer PHBs to patients with neurological conditions accessing the Community Neurology Service
  • Explore PHBs in children’s continuing care
  • Explore PHBs in mental health, short term residential care
  • Explore PHBs with patients with working age dementia living in the community
  • Explore PHBs for people with ME

Any Questions?

Gemma Newbery


Tel: 0115 883 9474