Planning and Funding Long-term Care in the UK

Personal health budgets

Suitable for: anyone who needs homecare support

Personal health budgets are funded by the NHS. They are an optional way of achieving your health and wellbeing goals, giving you greater control over decision-making.

A personal health budget can either be self-managed or managed by the NHS team or a third party. If self-managing, you will receive Direct Payments to spend on healthcare services you have chosen and arranged yourself. 

Alternatively, the NHS team or a third party will support you to identify the services you need. They will also arrange and pay for the services on your behalf. Personal health budgets are fully funded by the NHS and cannot be ‘topped up’. 

Find out more about personal health budgets on the NHS website.

Choosing How to Receive Your Personal Budget

Once your personal budget has been determined, you have several options for how you receive and manage it:

• Council-Managed Budget: The council retains control of the funds and arranges your care on your behalf. This option might suit you if you prefer not to manage the logistics of your care directly.
• Third-Party Management: You can have the funds paid to an organisation, such as a care provider, which will then manage your care according to your care plan. Be aware that some organisations may charge for this service.
• Direct Payments: If you wish to take full control, the funds can be paid directly to you or someone you trust. This option, known as direct payments, offers the most flexibility and autonomy in managing your care.

You can also opt for a mixed package, where the council manages part of your budget while the rest is given to you as a direct payment.

The Benefits of Direct Payments

Direct payments are an excellent option for those who value independence and want to tailor their care to their specific needs. Here’s how direct payments can benefit you:

• Personalised Care: You can hire care workers or personal assistants who align with your preferences, such as language, culture, or experience in handling specific needs.
• Consistency and Reliability: By hiring your own staff, you ensure that the same people are consistently involved in your care, providing familiarity and stability.
• Flexible Scheduling: Direct payments allow you to arrange care at times that suit your lifestyle, whether it’s help with morning routines or assistance with evening activities.
• Social Inclusion: You can use your budget to pay for support that enables you to participate in social activities, fostering connections and reducing loneliness and isolation.

Managing Direct Payments

Opting for direct payments means you take on the responsibility of managing the funds and ensuring they are spent according to your care plan. Here are some key aspects to consider:

• Record Keeping: You’ll need to keep records of how you spend the money. Most councils require evidence of spending every three months, so it’s important to stay organised.
• Employment Responsibilities: If you choose to hire your own carer or personal assistant, you will be their employer. This includes responsibilities such as conducting background checks, handling tax and National Insurance, and managing pension contributions.
• Support for Management: If managing the payments feels overwhelming, you can ask a trusted friend or family member to help. They can manage the payments on your behalf through a trust arrangement, ensuring the funds are used correctly.

When Direct Payments Might Not Be Suitable

While direct payments offer significant benefits, they may not be the best choice for everyone. You might consider other options if:

• You’re Uncomfortable Managing Finances: If you’re worried about handling the money or keeping records, the council can manage the budget for you, reducing the burden.
• Frequent Hospital Stays: If you spend a lot of time in the hospital, direct payments might not be practical as your care needs could fluctuate frequently.
• You Prefer Professional Management: If you would rather focus on your well-being and leave the care arrangements to professionals, letting the council or an agency manage your budget might be the better option.

Applying for Direct Payments

If direct payments sound like the right choice for you, the process to apply is straightforward. After your needs assessment, you should be offered direct payments as an option. If not, you can request them through your local council’s social services department.

The council will then arrange for the funds to be transferred to you, either via a direct bank transfer or a pre-paid card. It’s important to sign a direct payment agreement, which outlines how the money should be spent and your responsibilities if you choose to hire someone.

What If You Need Help Managing Your Direct Payments?

Managing direct payments can feel daunting, but there are resources available to support you. Your local council can provide advice, and organisations like Money Helper and Disability Rights UK offer guidance on managing your budget.

If you’re struggling, you might consider allowing someone else to manage the payments. This could be a carer, a family member, or an advocate who understands your needs. This person can help ensure that the funds are spent correctly and in line with your care plan.

Seeking Help and Making Complaints

If you need support managing your personal budget or direct payments, your local council is the first point of contact. Additionally, several organisations offer helplines, such as Disability Rights UK and Age UK, which can provide further assistance.

If you’re unhappy with how your personal budget is handled, or if you disagree with the council’s decisions, you have the right to make a complaint. Start by discussing your concerns with your social worker or the council’s social services department. If necessary, escalate the issue to the Local Government Ombudsman.

NHS Continuing Care Funding

Suitable for: outpatients who require ongoing care beyond hospital

If you have needs that result from disability, accident or illness, you might qualify for free NHS Continuing Care. This is also applicable to those with complex medical problems.

NHS Continuing Care Funding is only available for people who need nursing care rather than social care. It can cover healthcare costs, personal care, accommodation or support for carers if you are being looked after at home.

To find out if you are eligible for free NHS Continuing Care, you must first undergo initial screening. This screening is followed by a thorough assessment by a team of two or more familiar health and/or social care professionals. If your health is deteriorating rapidly, you can ask about a fast-track assessment to bypass the initial screening.

If you don’t qualify for NHS support at the first assessment and your circumstances change, you can request a review. You may still qualify for Local Authority funding for some of your care needs. 

Find out more about continuing healthcare on the NHS website.

And consider whether our homecare after hospital service might be right for you.

If you have questions about the cost of homecare, contact us today and we can guide you thought the options available. Find your local office.