Author and Publication
Author: Ben Slater, Registered Social Worker, Founder and Managing Director of Nellie Supports
Reviewed by: Kerry Slater, Director of Operations
Last reviewed: 20 July 2026
Citation
1. Department of Health and Social Care (2022) National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Available at: https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care
2. Care Act 2014, c. 23. Available at: https://www.legislation.gov.uk/ukpga/2014/23/contents
3. Department of Health and Social Care. Care and support statutory guidance. Available at: https://www.gov.uk/government/publications/care-act-statutory-guidance
4. R v North and East Devon Health Authority, ex parte Coughlan [2000] 2 WLR 622.
Copywright
Copyright © 2026 Nellie Supports Ltd. All rights reserved.
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This article does not constitute legal advice, clinical advice or a substitute for a decision-specific professional assessment. Where legislation, government guidance, court forms or external professional materials are referred to, those materials remain subject to their own copyright, licensing and re-use terms.
Abstract
This guide clarifies the relationship between NHS Continuing Healthcare and personal health budgets. It explains that a personal health budget is a means of receiving funding rather than a separate entitlement, distinguishes it from social care personal budgets and direct payments, covers the right to have one, the management options, and what changes and what does not when a budget is taken.
CHC and personal health budgets compared
Personal health budgets and NHS Continuing Healthcare are frequently spoken about as alternatives. They are not. One is an entitlement, the other is a way of receiving it.
They are not alternatives
NHS Continuing Healthcare is a funding entitlement arising from an eligibility decision. A personal health budget is a mechanism for managing that funding, giving the person more control over how their care is arranged. You do not choose between them. You become eligible, and then you may choose how the funding is managed.
The right to have one
Adults eligible for NHS Continuing Healthcare have a right to have a personal health budget. That right follows the eligibility decision rather than substituting for it. If a budget is being offered as a way of resolving a dispute without deciding eligibility, ask for the eligibility decision in writing, because the decision is what carries appeal rights.
How it differs from social care budgets
A personal budget or direct payment in social care arises under the Care Act and is means tested, so the person contributes according to their means. A personal health budget arises from NHS funding and involves no contribution at all. The two are structurally similar and financially very different, and the words are easily confused.
The management options
A notional budget, where the Board holds the money and arranges services to the agreed plan. A third party budget, where an organisation manages it on the person's behalf. Or a direct payment, where funds are paid to the person or their representative to arrange care directly. Each carries a different administrative burden.
What changes and what does not
What changes is control: choice of provider, continuity of carers, and flexibility in how needs are met. What does not change is the eligibility position, the assessed needs, the amount available, or the review arrangements. The budget reflects the cost of meeting assessed needs rather than being an entitlement to a sum.
Where the plan does the work
Because the budget is calculated from the care and support plan, the plan determines everything. A thin plan produces a thin budget however the money is managed. Time spent getting the plan right is therefore worth more than time spent on the budget mechanism, and it is the part families most often under-attend to.
Key takeaway
A personal health budget is how NHS Continuing Healthcare funding can be managed, not an alternative to it. Do not accept one in place of an eligibility decision, do not confuse it with a means tested social care budget, and concentrate attention on the care and support plan.
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Frequently asked questions
Is a personal health budget instead of CHC?
No. It is a way of managing NHS Continuing Healthcare funding once eligibility has been decided. The entitlement and the mechanism are different things.
Can we be offered a budget instead of an assessment?
You should not be. Ask for the eligibility decision in writing, since the decision carries appeal rights and a budget arrangement does not resolve the underlying question.
Is it the same as a social care direct payment?
No. A social care personal budget arises under the Care Act and is means tested. A personal health budget arises from NHS funding and involves no contribution at all.
Related NHS Continuing Healthcare pages
These links take you to the most relevant Nellie Supports service page and to the supporting guides that explain the surrounding process.
Speak to an independent CHC specialist
Nellie Supports prepares independent needs evidence for NHS Continuing Healthcare assessments, reviews and appeals across England and Wales. Our reports are written by registered social workers on a permanent employed team, with internal peer review before release. Call 0333 987 5118 or send an enquiry and we will talk through where you are in the process.