People in Fylde and Wyre who have ongoing and complex healthcare needs can see changes to the way they receive and can use funding for their care starting this month.

From October 2014, people with complex, intense and unpredictable healthcare needs and who receive NHS Continuing Healthcare funding, will have the right to ask for a personal health budget, as an alternative to a traditional service. A personal health budget is an amount of money to support a person’s identified health and wellbeing needs, with their support plan agreed between the person and their local NHS team.

In Fylde and Wyre, a small number of people with complex long-term health needs have NHS Continuing Healthcare funding, but personal health budgets can provide huge benefits for those individuals.  The aim is to give people more choice and control over the money spent on meeting their healthcare and wellbeing needs.

This means that they choose services that meet their needs in a way that is most suitable for them.

Dr Adam Janjua, local GP and vice chair at NHS Fylde and Wyre Clinical Commissioning Group, said: “Personal health budgets can make a significant difference to a patient’s quality of life and help them stay out of hospital.

“Personal health budgets make planning the care people need much more flexible. Working with their local NHS team, patients will be able to use their budget for a range of things to help meet their goals, including personal care and equipment.”

Taking up the offer of receiving a personal health budget will be voluntary, and anyone who does not want to manage their healthcare needs in this way can leave their care arrangements as they are now.

ENDS

 


 

Questions and answers

Who can have a personal health budget?

From 1 October 2014, adults who are eligible for fully funded NHS Continuing Healthcare funding, and children eligible for NHS continuing care, have a right to have a personal health budget. Your Continuing Healthcare funding and care package will remain in place if you choose not to have a personal health budget. It is completely voluntary

What is a personal health budget?

A personal health budget is an amount of money, paid to you by the NHS to meet your healthcare and wellbeing needs; planned and agreed between the person or their representative and the local NHS team. You will be able to use your budget for a range of things to help you meet your goals, including personal care and equipment.

What does this mean for me?

People who are eligible for NHS Continuing Healthcare and Continuing Care for children will have much more say over how their health and wellbeing needs are met. If you are receiving direct payments through social services, you may be able to transfer to a personal health budget with minimal or no disruption to your current arrangements if you become eligible for NHS Continuing Healthcare.

How does it work?

There are three key steps to meeting health and wellbeing needs under the personal health budgets system:

  •  Step 1 – assessment of needs
  • Your care coordinator will ask you questions to find out what you need for your health and wellbeing.
  • Step 2 – budget allocation
    Your assessment of needs is used to work out an ‘indicative budget’. An ‘indicative budget’ is an estimate of the money needed to meet your health and wellbeing needs.
  • Step 3 – support planning and using the budget
    Your care coordinator will then work with you, and those who support you, to decide how best to use the personal health budget to meet your needs. This will include your choice of how care is delivered. This is written in a support plan, which both you and your care coordinator must sign. While it can take some time to set up your health budget, we will make sure that this does not cause a delay in being discharged from hospital and an interim care package may be offered.

Will it affect my benefits?

A personal health budget is not a welfare benefit and is not a part of the benefits system. This means that a personal health budget is not taken into account when calculating your benefits entitlement. Personal health budgets are given in order to meet health and wellbeing needs, and cannot be spent for any other reason. We have a duty to make sure that payments are being used for what has been agreed with your care coordinator and documented in your support plan. We are entitled to recover any money that is not spent appropriately. Whatever form of personal health budget is used, the assessment and review process for Continuing Healthcare remains as it is now.

Where does the money come from?

The funding comes from the same pot of money that pays for either fully funded NHS Continuing Healthcare or Continuing Care for children.

How will personal health budgets work for me?

The budgets could work in three ways:

  1.  Direct payments – This is where either you or one of the agreed support service suppliers holds the funds to buy the care and support you and your local NHS team decide you need. For audit purposes, you or your support service supplier will have to show on what the money has been spent. You will be the employer and will buy and manage the service yourself, supported by the support service supplier as your human resources advisor.
  2. A notional budget – With a notional budget no money changes hands. You find out how much money is available and then 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.
  3. A budget held by a third party – This is where a non-NHS organisation holds the money for you and helps you decide what you need. After you have agreed this with your local NHS team, the organisation buys the care and support you have chosen, and they become the employer.

Do I have to have a personal health budget?

People do not have to change the healthcare and support that is working well for them, but if there’s something that isn’t working, that can be changed.

What can my budget be spent on?

The aim of personal health budgets is to allow you real flexibility in planning the care that you need. Personal health budget are intended to be used for a range of services to help meet people’s goals, such as personal care and, in some cases, selected equipment. People will not pay for emergency care or normal care from a family doctor from their personal health budget.

What can’t my budget be spent on?

People are not allowed to spend the money on gambling, debt repayment, alcohol, tobacco, or anything unlawful. The personal health budget cannot be used to part-fund treatments alongside patients’ own money. If a patient for any reason wanted to buy extra care, privately, this would need to take place separately. However, a patient could use their budget to buy private services that meet their personal health outcomes e.g. a private physiotherapist.

Can I employ a relative?

Usually, no. We will need to confirm that it is necessary to employ a relative / partner or anyone living in the same household as you, in order to satisfactorily meet your care needs for that service; or to promote the welfare of a child for whom direct healthcare payments are being made. If family members, close relatives and / or people living in the same household as you are to be employed, using a direct healthcare payment, the we must agree and record this in the care plan.

Will I be asked to show how I have spent the money?

Yes, patients will need to keep basic records. Your personal health budget bank account will be audited. Personal health budgets can only be used as agreed in your personal health budget care plan. The records will be subject to audit arrangements. The balance of the bank account will be reviewed regularly and any money that has not been allocated to your care or support, apart from the contingency funds, will be returned to your CCG (unless a prior agreement has been made with the care coordinator).


 

For further information please contact the media team on 01772 214213.