Make Sure You Are Offered a Personal Health Budget (PHB)!
What is a Personal Health Budget?
Since October 2014, anyone awarded NHS Continuing Healthcare Funding (CHC) should be offered the option of having a Personal Health Budget (PHB) and be supported to do so. This duty on your local NHS Integrated Care Board (ICB) applies regardless of the setting where care is provided, and even if you receive FastTrack CHC funding.
A PHB is a set amount of NHS money allocated to support your health and wellbeing needs, such as treatments, equipment and personal care, in a way that suits you.
PHBs are personalised to your particular care plan and are managed in collaboration with your local NHS PHB team.
It isn’t “extra money” — rather, it repurposes your existing NHS CHC funding more flexibly, in a tailored way, to maximise the benefit to you and your desired goals. In that way, you can use the funds to serve/enhance your assessed CHC healthcare needs and priorities, and meet the outcomes you want to achieve, and in way that suits you best. With careful thought, PHBs can deliver better outcomes for an individual’s care.
Unless there are exceptional circumstances, or value-for-money considerations apply, it is expected that anyone receiving CHC at home will ordinarily be offered a PHB.
The obvious advantage of a PHB is that it give you more choice, control and flexibility over your budget, rather than having others dictate how funds should be allocated for your needs. You have control over how the money is spent and therefore have a say in what is right for you.
If you are not offered a PHB, quote paragraph 321 of the National Framework for NHS Continuing Healthcare and NHS‑funded Nursing Care (updated July 2022):
321 “Individuals who are eligible for NHS Continuing Healthcare have had a right to have a Personal Health Budget since October 2014. Personal Health Budget Standing Rules require ICBs to provide people eligible for NHS Continuing Healthcare with information about Personal Health Budgets to offer them the option of taking them up, and support to do so.”
The process is built around a Personalised Care and Support Plan (PCSP), jointly created with you and the NHS team, based on the six key features of PHBs:
- You are central in planning your own care
- You define the health and wellbeing goals you want
- You receive an upfront indication of your budget amount (i.e. how much you have to spend)
- The budget covers all agreed needs
- You choose how it’s managed: whether notional, third‑party or direct payment (or a hybrid mix) – see below
- You use the money in ways that fit your life and outcomes
⚠️ Tip: If you’re unsure, reach out to your local ICB or regional PHB team to start your conversation.
Choose the right budget‑management approach
Personal health budgets can be managed in three ways or a combination of these, where some elements are self‑managed and others arranged by NHS or provider:
Notional budget
The NHS holds the funds and arranges care services directly for you. This option reduces administration while retaining choice and allowing input over your care. In practice, this is the most common option.
Direct payment
You receive the cash funds and arrange support and agreed services yourself. This option gives the most control and flexibility, but requires more administrative responsibility.
Third‑party budget
An independent provider/organisation manages the money and delivers the agreed services. This option also reduces administration while retaining choice (but is the least common option).
What can you spend it on?
With NHS approval, you can use the PHB to pay for items in your agreed care plan such as personal care, therapies, equipment, support services (e.g. carers, transport, respite, assistive technology), or creative wellbeing activities — as long as they fit with your agreed outcomes, risk parameters, and are value for money. Support is available from your PHB team to help you use your budget to maximum effect.
Prohibited uses
- Emergency care (e.g. A&E hospital admissions, GP appointments, dental treatment & routine medication)
- Gambling, paying debts, alcohol, tobacco or anything illegal
- Paying a live‑in carer who is your relative (except in very rare cases)
If I have a PHB will I have to manage my own care?
No. You will not have to do everything on your own. PHBs just reallocate how the money will be spent to meet your needs.
Will I have to pay towards my healthcare if I can afford it?
No. There should be enough money in your PHB to pay for your care needs.
Stay agile — review and adapt
PHBs should be reviewed periodically, especially if your condition changes or outcomes aren’t being met. If you underspend or overspend, work with your PHB team to resolve adjustments. Healthcare won’t stop but plans may shift.
⚠️ Tip: Don’t be afraid to ask for a review if your circumstances change.
Seek support
Don’t be afraid to seek help:
- Many people benefit from PHB support services or local brokers who can help with planning, managing money and hiring staff
- Local ICBs and NHS England offer support networks and online guidance tools.
Final thoughts
A PHB isn’t necessarily the right choice for everyone, but for those eligible, it empowers choice, flexibility and the chance to shape your own care and support, living on your terms, and using NHS spending to support your healthcare needs. If used thoughtfully, PHBs can add real value and improve satisfaction and outcomes, at no extra cost.
If you’re exploring PHB options, gather clear documentation of your daily needs, talk openly with your CHC co‑ordinator, and choose the budget‑management style that fits your life.
Make your PCB work for you!
Resources and Support
- National Framework for NHS Continuing Healthcare and NHS‑funded Nursing Care
- For more information about personal health budgets, visit: NHS England’s Personal Health Budgets website
- Search our Care to be Different website for more blogs and insights
- Buy our book: How To Get The NHS To Pay for Care
Contact us
- ✉️ Email: enquiries@caretobedifferent.co.uk
- Call: 0161 979 0430
- Get professional advice from Farley Dwek Solicitors
- ⚕️ Access our Nurse Advice Helpline
The subject of PHBs was specifically requested by an enquirer who wanted more information on this subject. If you have a particular topic that you would like us to explain, please leave a comment below:
We’ve just started the process of applying for a PHB for my mum. It’s been a bit overwhelming, so this information is very reassuring.
Am I correct that the personal budget cannot be spent on health professional services eg occupational therapists and nurses because it is expected that the NHS will deliver the health professional services and direct/support carers to deliver delegated nursing & therapy ? What if there are no nhs nurses and allied health professionals?
How easy is it in practice to get a PHB agreed? I imagine the NHS can be quite resistant?
Thanks for the detailed explanation. The point about PHBs giving more choice and control is so important. How often should someone request a review if their condition is changing quickly?
Really helpful detail about what PHBs can be spent on. Do NHS teams generally approve things like transport and respite care easily, or does it vary a lot by area?
Do PHBs cover things like complementary therapies if they’re shown to help with wellbeing, or are they usually restricted to standard treatments?
This is such a clear explanation of Personal Health Budgets. I didn’t realise they’ve been a legal right since 2014. Do many people still miss out simply because they aren’t told about them?
I’d never even heard of PHBs before. Articles like this are so important.
I appreciate how clearly this explains what you can and can’t spend a PHB on. That’s always been a grey area for me.
Has anyone here managed to get creative wellbeing activities approved under their PHB? I’d love to know what kind of things the NHS will actually sign off on.
Wait… so PHBs have been a right since 2014 and no one talks about it?? That’s actually wild.
Feels like NHS doesn’t exactly shout about this… why do we always have to dig for info that should be offered straight up…..
Be reallybl careful!
A PHB sounds brilliant in principle, but beware it could become a nightmare.
As a PHB holder, responsibilities fall to you to manage everything. Great in principle, but let’s just look at one area.
If you rely on care coming into yóur home, you will know and understand the challenges this throws up. One challenge is staff turnover. If staff suddenly leave, it is difficult to find replacement staff. With advertising, interview and training it can take months.
Having had full CHC funding for over 20 years, and working within the voluntary sector as a disability campaigner, I absolutely know the pros and cons associated with PHBs.
It is for that reason I insisted on a notional budget. It works perfectly. All the control, with no responsibility. Also, when I go into hospital (including A&E), my care team stay with me. I figured out the funding maze and it can definitely happen!
So, my recommendation is to think very carefully before accepting the responsibility of a PHB. It comes with a LOT of responsibility, which may be OK for some but not for me.