About personal health budgets

A personal health budget makes it clear to someone getting support from the NHS and the people who support them how much money is available for their care and lets them agree the best way to spend it.

We do not think this will save money. We want to help people get a better service from the NHS without it costing more. The budget itself might not be that important - but we hope it helps people take full part in discussions about their care. Most importantly, we hope that this effect - more open and honest discussions about what people want to change about their health and wellbeing - reaches to people who do not have personal health budgets as well as people who do.

Key points

• NHS values still hold - no one will pay their own money to get services they need.
• Services should be safe and effective. Using them should be a positive experience.
• Personal health budgets should be a way of helping people who may not always get the best out of the NHS to get a better service, not make things worse.
• No one will have to get their services in this way if they do not want to.
• You should have as much control over decisions as is appropriate
• Organisations should work in partnership with you and with each other

We think personal health budgets could work in 3 main ways:

1. Notional budget. No money changes hands. The person finds out how much money is available and talks to their doctor or care manager about the different ways to spend that money on meeting their needs.
2. Real budget held by a third party. A different organisation or trust holds the money for the person, helps them decide what they need and then together they buy the services you have chosen.
3. Direct payment. The person gets the cash to buy the services they and your doctor or care manager decide you need. They have to show what they spend it on, but they buy and their manage the services.

1 and 2 are possible now. The Health Act, which received Royal Assent on 12 November 2009, will extend these options by allowing selected primary care trust sites to test direct payments as part of a pilot. As part of this process, the Department of Health held a consultation on proposals for direct payments for healthcare regulations and guidance. The consultation closed on 8 January 2010 and a formal response will be published in due course.