PERSONAL HEALTH BUDGETS
Who is eligible for a personal health budget?
Eligibility for a personal health budget depends on a person’s health needs, the type of NHS funding involved, and the local NHS arrangements in place.
ILBP helps NHS teams, families and partner organisations understand when a PHB may be appropriate and how a managed account can support safe delivery.
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In England, adults and children eligible for continuing care have a legal right to a PHB. The right also covers people eligible for section 117 aftercare and eligible NHS wheelchair users. Local ICBs can offer PHBs to other groups.
Continuing Healthcare
Adults eligible for NHS Continuing Healthcare have a legal right to a personal health budget for their agreed health and wellbeing needs.
Ongoing community needs
People with complex long term conditions receiving support in the community may also be offered a PHB under local ICB arrangements.
Children & young people
Children and young people eligible for NHS continuing care have a legal right to a PHB for the NHS funded part of their care.
What factors are considered?
The NHS confirms eligibility and agrees how a PHB will meet assessed needs. Local ICB policies also determine access for people outside the groups with a legal right.
The nature, complexity and continuity of the person’s health needs.
Whether the NHS is responsible for funding some or all of the support.
Whether there is a clear, achievable care and support plan.
Whether risks can be managed safely through agreed arrangements.
Local NHS / ICB policy on how PHBs are offered and reviewed.
When a PHB may not be the right fit
A PHB covers planned and agreed support. Some services or proposed spending arrangements may need a different approach. Where a direct payment is unsuitable, a PHB may still be possible through an NHS managed or third party budget.
Where emergency care, GP services or prescribed medicines must be arranged through usual NHS services.
Where a care and support plan still needs to be agreed.
Where risks cannot be managed safely through the proposed arrangement.
Where another statutory funding route is more appropriate.
How ILBP helps with PHB eligibility pathways
ILBP supports NHS teams and families once a PHB is being explored or agreed, helping ensure the financial side is practical, compliant and easy to monitor.
Helping teams plan how a managed or third party account would work.
Providing clarity on payment flows, records and reporting.
Supporting safe implementation once eligibility is confirmed.
Giving families and carers a clearer understanding of what happens next.
Quick guide
NHS Continuing Healthcare, children’s continuing care and section 117 aftercare include groups with a legal right to a PHB.
Eligible NHS wheelchair users have a right to a personal wheelchair budget when a new or replacement wheelchair or specialist buggy is needed.
Local ICBs can offer PHBs to other groups and explain the arrangements available.
Case studies
Examples of how personal health budgets, supported by managed accounts, can improve stability and outcomes.
No published case studies in this category yet.