1. Personal Health Budgets for NHS Continuing Healthcare: 10 features of an effective process Vidhya Alakeson

2. What is a PHB? 5 distinctive features:
The person knows how much money they have upfront .
The person chooses the outcomes to be achieved, in agreement with their health professionals.
The person is enabled to create their own support plan, with whatever support they may want.
The person freely chooses the way in which their budget is held and managed.
The person is able to spend the money flexibly to achieve their planned outcomes.
Source: DH, forthcoming

3. The basic 7 step PHB process
Engage the individual with the concept and purpose of a PHB
Identify the cash value of the PHB based on and individual’s needs
Support the individual to develop a support plan
Approve the support plan if it is within budget and meets identified needs safely
Support the individual to decide how the money will be held
Put the services and supports in the plan in place and life live
Review the plan and make changes if required

4. Agree a local framework to govern the process
Develop a peer network and involve everyone from the start.
Clarify the purpose and principles of a PHB.
Be clear about all aspects of the money
Develop and provide information, support and training.
Agree a local approach to choice, safeguarding and risk enablement.
Agree the criteria for signing off support plans
Agree the process of authorisation and appeals.
Agree how support plans will be monitored and reviewed.
Create a feedback loop to inform market development.
Create a local communication strategy and a plan for workforce development.
Source: DH, forthcoming

5. The 10 features of an effective process
A PHB covers the full range of an individual’s health and social care needs
The full continuing healthcare package is included within a personal health budget
Individuals know how much they have to spend before they start planning
The resource allocation system is based on needs not hours of care

6. The 10 features of an effective process
Clinicians are involved from the very beginning but do not dominate
Adequate support is available to PHB holders for support planning
The support plan is written in an individual’s own words and is not a clinical care plan
Individuals are in charge of decisions about training

7. The 10 features of an effective process
The approval process is light touch and transparent
There are adequate options available for how the PHB is held
And finally….
Embed PHBs into the existing CHC process rather than seeing it as an add on to create the necessary culture change in the NHS