PHB: referrals

Personal Health Budgets (PHB) are offered to adults receiving support from East London Foundation Trust (ELFT) to help them work towards a mental health recovery goal.

We recommend you speak with a PHB advisor before making a referral on PHB@advocacyproject.org.uk or 020 3869 9728.

To receive a PHB, the person must be:
- an adult (18+)
- receiving mental health support from East London Foundation Trust
- a resident of City and Hackney, Newham or Tower Hamlets
- have recourse to public funds, unless receiving S117 aftercare (see NHSE right to have guidance, section 4.4.
Please note: if you're referring someone for a PHB through primary care, please contact us on the details above.

To make a referral to the service:
- complete the referral form with the person referred for a PHB [please note the referral form includes a "quality of life" questionnaire that must be completed by the person]
- submit a PHB plan that has been completed with the person and offer them a copy
- collect authorisation at the appropriate level.
Please mark this box to confirm that the person you are referring meets the eligibility criteria*
- I confirm that the person I am referring to The Advocacy Project for a PHB meets the eligibility criteria

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About the referrer
Referrer's name*
First Last
Phone
Mobile
Email*

We'll send you a copy of the information you give on this form to this email address.
Borough*
Job title*
Hackney team*
Tower Hamlets team*
Newham team*
Does another health professional need to know about this referral?
Name - other professional
First Last
Email - other professional

We'll send a copy of the information you give on this form to this email address.
Job title - other professional
Team - other professional

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Communication
Language spoken
Communication support required or used
Communication professional required
Communication observations
What do we need to know about their communication needs?
Preferred contact method
Preferred information format

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Additional information
Using the Personal Health Budget safely
What risks need to be considered and how will these be managed?
Confirmation*
PHB Guidance
- I, the referrer, have read the guidance around using PHB safely and have discussed this with the person I am referring
Additional information
Please tell us anything else you think will help with this referral
Please complete and attach the PHB plan.
Please also ensure that you go through the PHB information sharing document with the person you are referring, before submitting the plan.
Please attach the support plan
Max. file size: 100 MB.

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Purchases
Please see the guidance notes for more information about payment type, or contact the PHB team
How many products and/or services would you like to request*
The number you select will determine the number of product and/or service sets of question you see
How will the purchase be made?*
Product or service 1
Product /service*
Name of the provider*
Quantity (number of sessions/products)*
Unit cost (cost per session or product)*
Total cost of this product or service
Quantity x unit cost
Payment type*
Please see the guidance notes for more information about payment type, or contact the PHB team

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Product or service 2
Product /service
Name of the provider
Quantity (number of sessions/products)
Unit cost (cost per session or product)
Total cost of this product or service
Quantity x unit cost
Payment type
Please see the guidance notes for more information about payment type, or contact the PHB team

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Product or service 3
Product /service
Name of the provider
Quantity (number of sessions/products)
Unit cost (cost per session or product)
Total cost of this product or service
Payment type
Please see the guidance notes for more information about payment type, or contact the PHB team

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Approval
£0 – £250 – Approval by assessing Clinician
£251 – £749 – Approval by Team Manager
£750 – £1000 (or greater by exception) – Approval by Team Manager and then sent to e-approval for final authorisation.
Total budget*
The total cost of all activity and purchases
If the budget is above £250 please complete the information below
Approving manager's name
If required
First Last
Approving manager's phone
Approving manager's email
If the value of the services or products exceeds £250, have you discussed this with your manager?
- Discussed with manager

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Permission for us to use this data*
- Please check the box if you understand that by submitting this personal information you are consenting to The Advocacy Project holding and using it in accordance with our privacy policy.
Please note we may share this referral information with one of our partner organisations if they are delivering the service you need.
Please see our privacy policy
If you need help or have questions about any aspects of the Personal Health Budget process please contact us:
Phone 020 3869 9728 or
Email PHB@advocacyproject.org.uk
Name
This field is for validation purposes and should be left unchanged.

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About the referrer