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. The Care and Support (Charging and Assessment of Resources) Regulations 2014, SI 2014/2672.
Copywright
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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 explains personal health budgets for people eligible for NHS Continuing Healthcare. It covers what a personal health budget is, the right to request one, the three ways a budget can be managed, how the amount is determined, what it can and cannot be spent on, the care and support plan, and the review arrangements.
Personal Health Budgets under NHS Continuing Healthcare
A personal health budget gives someone eligible for NHS Continuing Healthcare more control over how their care is arranged. It is not extra money, it is the same funding managed differently.
What it is
A personal health budget is an amount of NHS money allocated to meet a person's assessed health and wellbeing needs, planned and agreed between the person and the Integrated Care Board. Adults eligible for NHS Continuing Healthcare have a right to have a personal health budget, and it is one of the main groups for whom the arrangement was designed.
The three ways to manage it
A notional budget, where the Board holds the money and arranges services in line with the agreed plan. A third party budget, where an organisation holds and manages it on the person's behalf. Or a direct payment, where the money is paid to the person or their representative to arrange care themselves. Each carries different administrative demands.
How the amount is set
The budget reflects the cost of meeting the person's assessed needs, not an entitlement to a sum. It is calculated from the care and support plan and should be sufficient to meet the needs identified. Where the plan is thin, the budget will be too, so the assessment and plan matter as much as the budget conversation.
The care and support plan
The plan sets out the needs, the outcomes to be achieved and how the budget will meet them. It is agreed between the person and the Board and should reflect what matters to the person as well as the clinical requirements. Time spent on the plan is well spent, because everything else follows from it.
What it can be spent on
Anything agreed in the plan as meeting assessed needs, which can include employing personal assistants, choosing a particular provider, or arranging support in a way that suits the person better than a standard commissioned package. It cannot be spent on things excluded by the Board's policy, on gambling, debt repayment or alcohol and tobacco.
Employing carers directly
A direct payment allows the person or their representative to employ personal assistants directly, which offers real continuity and control. It also brings employer responsibilities including contracts, payroll, insurance and pensions. Many areas provide a support service to help with this, and it is worth asking what is available before deciding.
Key takeaway
A personal health budget is the same funding managed differently, with more control over how care is arranged. The care and support plan drives the amount, so focus attention there, and consider the administrative demands before choosing a direct payment.
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Frequently asked questions
Who can have a personal health budget?
Adults eligible for NHS Continuing Healthcare have a right to have one. It is one of the main groups the arrangement was designed for, and you can ask the Integrated Care Board about it at any point.
Is it extra money?
No. It is the same funding managed differently, reflecting the cost of meeting assessed needs. What changes is the degree of control over how care is arranged, not the amount available.
Can we employ our own carers?
Yes, through a direct payment. It offers real continuity and control but brings employer responsibilities including contracts, payroll, insurance and pensions. Ask what support service is available locally.
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.