Personal budgets for care, health, and education

There are three types of budgets for social services provided to children, young people, and adults. These are:

• SEND personal budget for children and young people
• personal health budget (NHS) 
• adult personal budget.

A SEND personal budget is an amount of money we identify with the Clinical Commissioning Group (CCG) to provide in an education, health, and care plan (EHCP) where the parent or young person is involved in securing that provision. The scope of a personal budget will vary depending on individual circumstances but is aimed at services where the parent or young person can be involved in securing the provision.

Where it is possible to make a SEND personal budget available, there are four ways to deliver it:

• through our children’s or adult social care service and CCG, where the school or the college holds funds and commissions support based on assessed needs to meet the outcomes specified in the EHCP
• through a third party that's paid the funds and manages the personal budget on behalf of the parents or young person. There are no additional funds to do this, it comes out of the assessed need allocation provided
• through a direct payment, where funds are paid into a separate bank account and managed by the parent or young person
• through a combination of these options.

SEND Personal Budgets (0 to 18 years old)

There are separate legal frameworks about the making of personal budgets and direct payments for Education, Health and Social Care. However, the Special Educational Needs and Disability reforms from September 2014 bring together the potential for joining up service areas into a holistic personal budget when an Education, Health and Care Plan (EHCP) is made. This is a developing picture as the agencies work together across the age ranges 0 to 25 years to see how this might operate. This is a complex area and will be kept under review as part of an ongoing process.

The position on the Isle of Wight across Education, Health and Social Care is:

• parents and young people will have the option of requesting a SEND personal budget, but it is not compulsory to do so. A SEND personal budget is an amount of money identified to deliver parts of the provision set out in the special educational provision section of the EHCP. The elements of the total provision over which parents or young persons can have a say are those which form a personal budget
• a SEND personal budget is not available unless the child or young person has an EHCP. A personal budget can be requested at the point when a draft EHCP is issued or an EHCP is reviewed at the annual review or as part of a statutory reassessment of the child or young person’s special educational needs.

A SEND direct payment can be provided for a child or young person with an EHCP when the Local Authority is satisfied that:

• the SEND direct payment will be used to make the special educational provision specified in the EHCP, for instance, educational resources cannot be used to buy additional short break time
• making a direct payment will not have an adverse impact on other services we provide for children and young people with EHC Plans, for instance, Specialist Teacher Advisors (STAs)
• securing the agreed provision by a direct payment does not create an additional cost for the Local Authority. The arrangement does not cost anymore, for instance, Specialist Teacher Advisors (STAs)
• the Head teacher of the school or the Principal of the college where the agreed provision will be provided is in agreement with a direct payment being made.

In addition, the SEND direct payment cannot be used to fund a place at a school or college. No new money is being introduced into the education system to fund personal budgets and any personal budgets must come from existing resources.

On the Isle of Wight the arrangements made for delegating funding to schools and colleges for places and the additional top up provided to fund the special educational provision for children and young people with EHCPs means that the vast majority of money is spent on staffing and other day to day support costs.

The way that schools and colleges meet the needs of children and young people with special educational needs and disabilities including those with EHCPs is set out in the Local Offer. The potential for a personal budget varies depending on individual circumstances. However, for the majority of children and young people in a school or college setting the opportunity for a personal budget for special educational provision is very limited.

All requests for a personal budget will be considered on the individual circumstances of the child or young person. Contact the SEN Service Assessment and Review team for more information.

Since September 2014, a SEND personal budget is available for children and young people through Children's Services. Parents and young people have the option of requesting a personal budget, but it will not be compulsory for the child or young person and family to do so.

A SEND personal budget must be used to meet assessed needs and outcomes. No new money is being introduced into the system to fund personal budgets and any personal budgets will come from existing resources.

Having a SEND personal budget encourages creativity and flexibility. We would like plans to be personalised so that they properly reflect the individual the individual outcomes of each child/young person and family as long as they are effective in meeting the care needs and outcomes specified within the EHCP. Plans should be legal, affordable and within the budget allocated by the Local Authority.

View the full eligibility criteria.

To apply for a personal budget: download, complete, and return the Personal Budget form to the SEN Assessment and Review team.

Children’s NHS (birth to age 19)

Personal Health Budgets (PHB) are for children and young people since October 2014. In the first instance, the approach is being offered for those who qualify for continuing care.

Children in Transition

Our adult social care services and the Clinical Commissioning Group's (CCG) Continuing Healthcare team works with Children’s Services (for health and social care) to support us to develop processes and pathways which will enable children in transition to have personal budgets. The principles of offering a personal budget for children or a personal health budget for adults (as a direct payment) are very similar.

The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (November 2012 (Revised) transition from child to adult services paragraph 124 to 138 for adults requests that children in transition are assessed at age 16 years, or earlier if possible, by a multidisciplinary team to agree their ongoing needs and service requirements as they move into adulthood.

The Isle of Wight Local Authority and CCG will be working together to ensure a smooth transition to adult services.

Support plans

The implementation of PHBs will allow people to have more choice, flexibility and control over the health services and care they receive. At the heart of a personal health budget is a support plan. The support plan is an agreement between the NHS and the individual that sets out the person’s healthcare and wellbeing needs, the amount of money available to meet those needs and how this money will be spent.

For more information, contact:

• email susan.thomas12@nhs.net
  
• Susan Thomas, Designated Clinical Officer
• NHS North East Hampshire and Farnham CCG.

A personal budget for social care is the total amount of money which Adult Services has identified to meet a person’s eligible social care needs, following a social care assessment. The personal budget is recorded within the person’s personal plan which demonstrates the person’s outcomes, the activities or services identified to meet these, along with the associated cost.

The outcomes are derived from the personal assessment of need, discussed and agreed with the person, and how it is intended they will be met. Planning of the support to meet the outcomes can be done jointly with the person and the Adult Services practitioner or independently.

Once the care package is in place, the needs, outcomes and personal budget are reviewed in line with Adult Services review procedure.

If you have further enquiries, please contact your allocated practitioner.

The Adult Social Care - Information and Advice service provide various factsheets online, you can access all of them on the factsheet.

Isle of Wight adults eligible for NHS Continuing Healthcare in Hampshire has been running for the last year. From October 2014, there was a statutory obligation on Clinical Commissioning Groups (CCGs) to provide a PHB for appropriate individuals who are eligible for NHS Continuing Healthcare.

The implementation of PHBs will allow people to have more choice, flexibility and control over the health services and care they receive. At the heart of a personal health budget is a support plan. The support plan is an agreement between the NHS and the individual that sets out the person’s healthcare and wellbeing needs, the amount of money available to meet those needs and how this money will be spent.

For more information, contact:

• email susan.thomas12@nhs.net
• Susan Thomas, Designated Clinical Officer
• NHS North East Hampshire and Farnham CCG.