Personal Health Budgets & Direct Payments

Personal Health Budgets Dave Ogier, Personal Health Budget Supervisor. Mohammed Ditta, Personal Health Budget Officer. Housekeeping. What are Personal Health Budgets. The process. Direct Payments as an outcome of a Personal Health Budgets. Questions at end of presentation.

Personal Health Budgets A personal health budget is an amount of money to support a person's identified health and wellbeing needs, planned and agreed between: The Continuing Healthcare team (CHC) acting on behalf of the Airedale Wharfedale and Craven Commissioning Group, Bradford District Commissioning Group, Bradford City Commissioning Group, (CCG’s). The individual, person receiving care. Their representative or nominee. Or, in the case of children, their families or carers.

Personal Health Budgets Personal Health Budgets(PHBs) are an important part of personalising approaches to healthcare. The use of PHBs is just one way in which the NHS can tailor services and support for people to enable them to have choice, control and flexibility over their health care. It is not new money. It is money that would normally have been spent by the NHS on a person’s care. The monies can be spent more flexibly to meet their identified needs.

Personal Health Budgets Following the pilots the Government’s commitment to Personal Health Budgets, included: April 2014; people eligible for NHS Continuing Healthcare (including parents of children) had the right to ask for a personal health budget, including a direct payment for healthcare. October 2014; People eligible for Continuing Healthcare have the right to have a personal health budget. April 2015; the right to ask will include people with mental health and long term conditions.

Personal Health Budgets There are three ways for people to receive and manage their personal health budget: A direct payment, for health care ; are monetary payments in lieu of services - made by CCGs to individuals (or to a representative or nominee on their behalf) to allow them to purchase the care and support they need. A notional budget; where the CCG makes the arrangements for the agreed care and support. A third party budget; where someone independent of the individual and the CHC holds the budget and makes the arrangements for the agreed care and support.

Personal Health Budgets The process, Support Planning: At the centre of the personal health budget is a support plan. It helps people to decide their health and wellbeing goals. The support plan is written to meet individual needs. It will set out how the budget will be spent. But remains based on assessed health needs. The senior nurse to check that outcomes will meet the health care need and are safe. Support plan to RAG to be agreed/authorised activating the payment (card).

Personal Health Budgets The process: In all cases the CCG remains responsible for ongoing assessments and reviews to ensure that the person remains eligible for CHC funding and that the assessed need for services can be met by a Personal Health Budget (direct payment).

Personal Health Budgets Direct Payment: One outcome of a Personal Health Budget is a direct payment. When thinking about if an individual could benefit from a direct payment for healthcare, there are a range of things to consider, for example. The person’s wishes and feelings in relation to their care and support and receiving direct payments. Their capacity to consent to the making of a direct payment and where appropriate the provision of support in the form of a nominee or representative.

Personal Health Budgets Direct Payment: Direct payments for healthcare will not be appropriate for all aspects of NHS care an individual may need. A direct payment cannot be used to purchase primary medical services provided by GP. A direct payment cannot be used for urgent or emergency treatment services, such as unplanned in- patient admissions to hospital or accident and emergency. A direct payment cannot be used for surgical procedures. A direct payment cannot be used to pay for any NHS charges.

Personal Health Budgets Direct Payment: A direct payment cannot be used;  To purchase alcohol or tobacco;  For gambling;  To repay a debt (with the exception of debts relating to services specified in the care plan).  In addition they cannot be used to purchase anything illegal or unlawful.

Personal Health Budgets Direct payments: How People are able to spend their personal health budgets/direct payments will be on solutions that really work for them in their lives. Whilst meeting their health and well-being needs as identified in their care plan, including;  Support at home.  Day care / social activities.  Respite care.  Equipment.

Personal Health Budgets Direct payments: People may wish to use their direct payment to employ staff to provide them with care and support. CCGs should support them to do so whenever possible, while ensuring that there is appropriate practical support as it could be their first experience as an employer. This support could include provision for payroll, training, sickness cover or other employment related services. CCGs should ensure that individuals are fully aware of their responsibilities, and of any potential risks and should be supported to manage them. This should be done accurately and responsibly, making recipients aware of what is involved without overstating the extent and complexity of these responsibilities.

Personal Health Budgets Direct payments: Benefits of being an employer. People can decide how they want their health needs met. People can choose who they employ. People can decide what days and times they want them to work.

Personal Health Budgets Payments are made onto an pre-paid card / electronic bank account. People can decide how they want their health needs met. People can choose who they I employ. People can decide what days and times they want them to work. Any questions?