You may have more choice over your care than you realise.
A Personal Health Budget can give you greater choice and control over how your NHS-funded care is arranged; including, in some cases, choosing the care provider yourself.
This guide explains how PHBs work, the different ways they can be managed, and what to ask if you want more say over who provides your care.
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If you or someone you love has a Personal Health Budget, or you’ve been told you might be eligible for one, you may have more choice over your care than you expect.
The important part is understanding how your budget is managed. That affects who arranges the care, who holds the money and how much practical control you have.
We’ve written this guide in plain English so you can understand your options before speaking to your NHS team or choosing a care provider.
A Personal Health Budget, or PHB, is an amount of NHS money allocated to meet your agreed health and wellbeing needs.
Rather than every part of your support simply being arranged for you, a PHB gives you greater involvement in deciding how your care is organised and how the available budget is used.
Your needs, the outcomes you want to achieve, the amount available and how the money can be used are set out in a personalised care and support plan agreed with your NHS team.
This includes certain groups such as:
Adults eligible for NHS Continuing Healthcare
Children and young people eligible for continuing care
People eligible for section 117 mental health aftercare
Eligible NHS wheelchair users through a Personal Wheelchair Budget
PHBs can also be offered more widely by local NHS services, so it is worth asking your NHS team even if you don’t fall into one of these groups.
A PHB is still NHS funding. The difference is that you should have meaningful involvement in planning how the budget is used to meet your agreed needs.
Having a PHB does not necessarily mean the money is paid directly to you.
There are three main ways the budget can be managed, and they differ in how much responsibility and practical control you take on.
Part of a PHB can sometimes be managed one way and another part differently, where this is agreed with your NHS team.
Then keep the comparison table, but change it to something more neutral:
Where it fits your agreed personalised care and support plan, a direct payment can be used to purchase care from a regulated provider.
That means you can have greater choice over who provides your care while the provider takes responsibility for employing, training and supporting the care team.
Neither approach is automatically better. The right choice depends on how much control, administration and employer responsibility you want. Some people use a combination of both.
You take on more control, and more responsibility.
This may include:
The provider employs and manages the care team.
Typically this includes:
Oria Care is a CQC-regulated, nurse-led care provider supporting people who use Personal Health Budgets to arrange care at home.
Depending on your assessed needs, agreed care plan and funding arrangements, we can provide:
Hourly home care
Live-in care
Longer daytime and waking-night support
24-hour care packages
Complex and clinically led care
Where care is funded through a PHB, we can work alongside your ICB, case manager and wider healthcare team, and provide the documentation and invoicing required for the agreed arrangement.
If you already have a PHB, tell us how it is managed and what care has been agreed.
If you’re still trying to understand your options, you can still speak to us, we’ll explain where Oria can help and what you may need to discuss with your NHS team.
No obligation. We can explain how Oria works with PHBs and what information we would need before care can be arranged.
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Are you CQC-regulated for the type of care I need?
Do you have experience with my specific care or clinical needs?
Who provides clinical oversight where nursing input is required?
Can you work with my ICB and provide the required records and invoices?
Can you deliver the agreed care within the available budget?
What happens if my needs or care plan change?
A PHB can be used for care and support that helps meet the health and wellbeing outcomes agreed in your personalised care and support plan.
What is appropriate will therefore differ from person to person.
Depending on the plan, this can include things such as:
Care from a regulated home care provider
Personal Assistants employed directly
Equipment and support agreed in the plan
Some therapy, activity or wellbeing support where agreed
A PHB is not intended to replace all NHS services. Things such as A&E, GP appointments, consultant appointments, medical tests and medication continue to be accessed through the NHS in the normal way.
There are also specific exclusions. For example, a PHB cannot be used for alcohol, tobacco, gambling, debt repayment or anything unlawful.
If you’re unsure whether something can be funded, ask your NHS team before committing the budget. The spend needs to fit the needs and outcomes agreed in your plan.
Yes, but there is an important distinction.
Your NHS funding should be sufficient to cover the care required to meet the assessed health needs and outcomes agreed in your plan. You should not normally be expected to add your own money simply to make that agreed NHS-funded care sufficient.
You can, however, choose to purchase additional private care outside the NHS-funded package, provided it is genuinely additional to the NHS-funded support and the arrangements are kept clearly separate.
For example, an NHS-funded package may cover agreed clinical support while a family chooses to pay separately for additional companionship or other support outside the funded plan.
Ask for a review before assuming you need to pay privately.
If your health or circumstances have changed, your assessment, care plan or budget may need to be reviewed.
If you’re unsure where the line sits in your situation, speak to your PHB team before arranging additional private care.
These are illustrative examples only. Individual PHB arrangements are agreed with the relevant NHS team.
The exact process varies depending on your circumstances and local NHS arrangements, but the journey usually involves the following conversations.
Which type of PHB are you offering me, and what other management options are available?
What is the indicative budget, and how has it been calculated against my assessed needs?
What exactly is included in my personalised care and support plan, and what isn’t?
Can the agreed budget be used with a regulated care provider of my choosing?
Can my package combine provider-delivered care with directly employed Personal Assistants where appropriate?
What records, invoices or receipts will you expect, and how often?
What happens to the PHB if I’m admitted to hospital?
How do I request an earlier review if my needs change?
Is there a local PHB or direct-payment support service I can use?
Who is my named NHS contact, and how do I reach them?
Already have a Personal Health Budget, or trying to understand whether one could work for your care?
Tell us a little about your situation and one of our team will call you.
We can explain how Oria works with PHBs, what information we would need from your NHS team, and whether we’re likely to be the right care provider.
There’s no obligation to arrange care.
We usually respond within one hour during office hours. You can also message us on WhatsApp.
