Personal Health Budgets

Personal Health Budgets: what they are and how to get one

A Personal Health Budget (PHB) is an amount of NHS money set aside to meet your health and wellbeing needs, which you plan and agree with your local NHS team. Instead of fitting into whatever services happen to be on offer, you have more say over what support you get, who provides it and when.

For some people, that means employing their own personal assistants. For others, it might be equipment, therapies, or a different way of arranging care at home. As disability rights campaigner Baroness Campbell of Surbiton, who relies on a PHB herself, puts it, having control over the support you receive can make all the difference to living an independent life.

Please note: Personal Health Budgets are an NHS England scheme. If you live in Scotland, Wales or Northern Ireland, jump to the section on the other UK nations.

 

 

Who has a legal right to a Personal Health Budget?

Since December 2019, four groups of people in England have had a legal “right to have” a Personal Health Budget:

• Adults who are eligible for NHS continuing healthcare (external link will open in a new browser tab or window), which is long-term care arranged and funded entirely by the NHS for people whose needs are mainly health needs.
• Children and young people who receive continuing care.
• People entitled to aftercare under section 117 of the Mental Health Act, following detention under certain sections of the Act (this does not include section 2).
• People who meet the eligibility criteria of their local wheelchair service, or who are already registered and need a new wheelchair or specialist buggy. This is known as a personal wheelchair budget.

These are not the only people who can have one. Integrated Care Boards (ICBs), which plan and pay for NHS services locally, are encouraged to offer Personal Health Budgets to other groups too. Some areas offer them to people with long-term conditions, learning disabilities or autism, or to help people leave hospital. If you are not in one of the groups above, ask anyway.

Wheelchair users will find much more detail about how personal wheelchair budgets work, including topping up the budget to get a better chair, in our guide to NHS Wheelchair Services.

 

What can a Personal Health Budget be spent on?

The budget is spent on whatever is agreed in your personalised care and support plan, as long as it meets the health and wellbeing outcomes you and your NHS team have identified. That gives a lot of flexibility. Examples include:

• Employing personal assistants or carers of your choice, trained to meet your particular needs.
• Equipment, including a wheelchair of your choice.
• Therapies, such as counselling, physiotherapy or hydrotherapy.
• Activities that support your health, such as exercise classes.
• Different ways of getting support at home, so you can stay out of hospital or come home sooner.

There are some things it cannot be used for. You cannot spend the money on gambling, alcohol, tobacco, paying off debts, or anything illegal. Emergency care, GP services and prescribed medicines are provided as usual by the NHS and do not come out of your budget.

 

How is the budget worked out?

The amount is based on an assessment of your health and wellbeing needs and what it costs to meet them. You (or someone representing you) then work with your NHS team on a personalised care and support plan, which sets out:

• Your health and wellbeing needs.
• The outcomes you want to achieve.
• How much money is in the budget.
• How it will be spent.

You should also be given a named care co-ordinator as your first point of contact if anything goes wrong. Your plan should be reviewed regularly, and you can ask for a review at any time if your needs change or the arrangement is not working.

 

Three ways to manage a Personal Health Budget

You can choose how much responsibility you take on, and you can combine the options:

• Notional budget: no money changes hands. You are told how much is available, you agree with your NHS team how it should be spent, and they arrange the care and support. This is by far the most common option, used for around four in five budgets.
• Third party budget: an independent organisation, such as a user trust or voluntary organisation, holds the money and arranges the agreed care and support for you.
• Direct payment for healthcare: the money is paid to you or your representative, and you buy and manage the agreed support yourselves. You will need to keep records of how it is spent. This is the option that gives the most control, and it is how many people employ their own personal assistants.

 

Personal Health Budgets, personal budgets and direct payments: what’s the difference?

The terms are easy to mix up:

• A Personal Health Budget is for your NHS healthcare needs.
• A personal budget is for social care needs, and comes from your local council.
• An integrated personal budget combines both health and social care money.
• A direct payment is not a type of budget but a way of receiving one, as cash you manage yourself.

If you already have a social care personal budget, you can have a Personal Health Budget as well, and you can ask for both to be paid into the same bank account.

 

How to ask for a Personal Health Budget

• If you are already getting NHS continuing healthcare, continuing care or section 117 aftercare, ask your care co-ordinator or the team that arranges your care.
• If you use NHS wheelchair services, ask about a personal wheelchair budget at your assessment or reassessment.
• Otherwise, contact your local Integrated Care Board. You can find your local ICB on the NHS website (external link will open in a new browser tab or window).

Do not wait to be offered one. Many people with a legal right to a Personal Health Budget are never told about it, and how often they are offered varies widely from one part of the country to another.

 

What if you are refused, or disagree with the amount?

If your request is turned down, you should be told why, and your ICB should explain how to appeal. If you are in one of the “right to have” groups, a refusal should only happen in limited circumstances, so it is worth asking for the reasons in writing.

If you disagree with the amount offered or the plan itself, raise it with your NHS team first. If that does not resolve it, you can make a complaint through the NHS England feedback and complaints process (external link will open in a new browser tab or window). A local advocacy service or Healthwatch can help you put your case.

You can also give up a Personal Health Budget at any time, and go back to having your care arranged in the usual way.

 

What about overspending or underspending?

Health needs change, and budgets can be reviewed. If you are running short, contact your NHS team as soon as possible: no one with a Personal Health Budget will be denied healthcare. If there is money left over, your team will discuss whether it is kept for your future needs or returned. Money spent on things that were not agreed in your plan may have to be paid back.

 

What’s next for Personal Health Budgets?

The government’s 10 Year Health Plan for England aims to double the number of people offered a Personal Health Budget by 2028/29, offer one to a million people by 2030, and make them a universal offer for everyone who would benefit by 2035. Take-up among people with an existing legal right is still patchy, however, and campaigners, including Baroness Campbell, have stressed the importance of making sure Personal Health Budgets remain genuinely available to those who need them.

 

If you live in Scotland, Wales or Northern Ireland

Personal Health Budgets as described above only apply in England. Elsewhere in the UK:

• Scotland: there is no NHS equivalent, but Self-directed Support (external link will open in a new browser tab or window) gives you choice and control over social care arranged through your local council, including direct payments to employ your own personal assistants.
• Wales: the Health and Social Care (Wales) Act 2025 allows adults eligible for continuing NHS healthcare to request direct payments for their care, with the change being introduced from April 2026. Ask your local health board how it works in your area. Social care direct payments are also available through your council.
• Northern Ireland: Self-Directed Support, including direct payments, is available through your local Health and Social Care Trust.

 

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Further reading and resources

NHS Wheelchair Services and personal wheelchair budgets
Baroness Campbell makes history with first AI-generated voice speech in the House of LordsSocial prescribing
More news and guides on the NHS and continuing healthcare
NHS: What is a personal health budget? (external link will open in a new browser tab or window)
Peoplehub: experiences from people with Personal Health Budgets (external link will open in a new browser tab or window)

 

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