1. Payment types
How much money someone is given in their personal health budget is determined by what they need to achieve their recovery goals. This includes both notional budget purchases and direct payment purchases.
Notional budget purchase
Some services are already funded by the CCG, and no extra payment is needed for the person to take part. The service will be included in the person’s recovery plan, and we need to take into account the notional value of what the person is receiving. This currently includes services run by Core Arts.
Direct payment purchase
If what a person needs isn’t already funded by the CCG or freely available, we’ll set up a direct payment. There are no set criteria for the amount of money we can allocate, but the referral must explain in detail why the item or service is the best way for the person to achieve their recovery goals. This is always assessed on an individual basis.
Our finance team set up a bank account for the person with Prepaid Financial Services (PFS) and deposit the agreed funds into the account for the requested item/ activity. Before the funds are organised, a Direct Payment Agreement (DPA) is completed with the person, this agreement outlines how the PHB must be used.
2. What can’t be funded by a PHB?
Here are some examples of things that can’t be funded by a PHB.
- Alternative therapy: this is sometimes funded under ELFT’s complex care budget; contact
- Something that will benefit someone connected to the budget holder, but not the budget holder directly – for example using a PHB to buy an item for a family member or friend
- Support for de-cluttering: this is available under City and Hackney’s self neglect and hoarding protocol
- Household items: funding support is available from Hackney Parochial Charities, Hackney Council discretionary crisis support scheme, Family Actions grants programme, Skinners’ Benevolent Trust, Percy Bilton Charity
- Travel costs for a journey out of the UK
- Driving lessons for people without a driving license
If you have any questions, please ask us before making a referral.
3. Ways to pay for direct payment purchases
- Direct online payment – for single or block bookings
- Prepaid card – for multiple payment arrangements
- Third-party provider – for single or block bookings
- Bank account – a new, separate bank account needs to be set up solely for receiving personal budget payments; it will only be used for high value, multiple payments and ongoing services such as domiciliary care
4. Approval limits
Direct payments need to be approved as follows:
- assessing clinician: £0 – £250
- team manager: £250 – £750
- team manager and CCG: £750 – £1000+
5. Clinical recommendation
The referral must include details of how the proposed purchases are clinically important for the person to improve their mental health. We need to know the reason for the overall budget size, how any direct payments have been chosen and other options that were considered such as group activities from the City and Hackney Wellbeing Network.
6. Long term sustainability
It’s unlikely a PHB would be available as a long term source of funding. Clinicians need to consider long-term sustainability, for example stepping down PHB-funded support over time as confidence grows, or the possibility of social care direct payments to continue support in the future.
7. Considering risks
PHBs are about enabling people to take positive risks. However, it’s still important for the team to consider any risks that might arise, and agree with the person how to manage these. This might include trying a new type of support for a short period then reviewing it with the clinician. For more information on this, see our guidance on using a PHB safely.