Personal Health Budget Support & Services
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What People Have To Say
What Services I Can Offer
Personal Health Budget Brokerage Service
- Personal Health Budget Brokerage Service
- Independent Advocacy for Personal Health Budgets
- Training and Workshops on Personal Health Budgets
- Personal Health Budget Consultancy
- Client-focussed PHB awareness and information service
- Monitoring and Evaluating the PHB Offer and Service for CCGs (and Local Authorities for joint-packages)
I am able to offer Personal Health Budget (PHB) Brokerage to support clients through the process, and equally to support Clinical Commissioning Groups (CCGs) and Local Authorities (LAs) with their PHB services and ensuring the best outcomes are achieved for all involved, not least the patient and family for whom this process is meant to improve their lives and achieve greater choice and control in their care.
This is done almost completely remotely unless the client is within travelling distance, with everything conducted via video and phone calls, emails and messages.
I offer Personal Health Budget (PHB) Brokerage to support clients through the NHS Continuing Healthcare (NHS CHC) and PHB process and/or to support reviews and reconfiguring of the package to meet changing needs. This is a paid service that can be commissioned by the Clinical Commissioning Group (CCG) – or a local authority in the case of joint funding – or purchased privately or from an existing care package if the CCG are unable to commission my services directly.
I work with the client to support them through the process, explaining information they need to know in a way that is understandable, providing emotional and practical support, leading on the development of their own or the patients’ personalised care and support plan (if working with a representative/parent/deputy) and then building the package itself, including helping the client to source agencies and services, and/or planning out how they will manage recruitment of staff to employ directly, sourcing PA/staff training, working out how they will manage the package itself (pure direct payment, managed account direct payment, third party budget or even a notional budget) and if going down the direct payment route, working out how you will manage the staff, what documentation is needed to be put in place (i.e. policies, staff handbook, care protocols), assessing and planning management of potential risks and creating a solid contingency for the package, so that we create within the personalised care and support plan all the costings to present to the CCG (and Local Authority if joint funded) to consider and decide upon.
I offer Personal Health Budget brokerage and assisting with care and support planning, in a paid capacity. Usually I am paid by CCGs or out of the individuals’ existing budget, otherwise I can be commissioned privately by the client but I always prefer trying to source funding other than from the pockets of patients and carers, recognising the cost associated with my work, and the often limited resources of clients.
The process is typically follows this pattern:
- Person contacts me, have a free introductory phone call if desired, we agree how it will work, method of payment, rough idea of a time period of hell needed (not fixed) and the individual signs the brokerage agreement — be that the patient/recipient of care, or the person’s representative, deputy, parent or guardian.
- We organise our first phone / Skype / Zoom call or face-to-face meeting if possible, to discuss the background, the needs, the requests for support, what’s happened so far, what the situation is, how they want to proceed etc.
- The individual then sends me useful documentation that will aid me in understanding them/the person they care for, including
- One page profile
- Doctors letter(s)
- Existing care plans (I know I have various care plans in various places),
- An hour by hour breakdown of care needed (if possible) or a summary of day to day care needs and any routines
- Any other useful documentation
- A photo of the patient because I find it incredibly useful to see the individual I am working to help or working with their representative to ensure they have the support they need. There’s something so special when I can see and connect with a client, even though I can’t always see them face-to-face. I also prefer to put at least one photo of the client in the personalised care and support plan, to help others reading the plan to also build that connection.
- Then this is where the process is tailored to the individual, so after this each case could follow a very different path.
However, at other times the CCG or Local Authority themselves have contacted me to commission my services rather than coming from a request from the patient.
Introductory Phone Call:
In the first call, I aim to build a picture of the patient/recipient including understanding needs, care and interventions, how those needs are met, their underlying conditions, level of complexity of need, etc.
I look at their goals and desired outcomes, hobbies, interests, likes and dislikes, wishes and preferences, what would a good day look like, what life means to them, activities they are or want to be engaged in, looking at social and wellbeing needs etc.
I also seek to understand the personal setup i.e. where they live and who with (at home with parent(s), independently, with partner, warden/supported living, residential care), who provides their care (parent/family, paid carers, district nurse input, hospice input, agency care) and how that care is spread out (for example that could be 6 hours daytime care, outside which the parent provides the care), and also who do they have around them for support.
Then anything else that may be relevant.
We will have other calls.
I begin to build a picture of the individual and start to pad out a personalised care and support plan.
We then agree a plan for moving forwards. Setting out the goals for my support, what and where help is most needed, what I can do, what actions I need to take, timeframes (without setting a fixed time limit unless that is desired or absolutely necessary) — everything is personalised to each client/case.
Then obviously we proceed with the plan we have built for my support.
In terms of time, I’ve had clients who have only needed 6 hours support, and others 40 hours and counting, so it all depends on the needs of the individual and family/partner/team. Even after the main intervention is complete, I am always happy to be contacted for advice and support, for example around reviews or if issues are arising, as I recognise that ability to have someone who is on the back burner can be so useful — with professionals however it’s usually once the intervention or acute need for service is complete, they are then discharged, and I don’t want patients/families to feel like they’re on their own.
What I don’t offer:
One thing I will say is I don’t offer to manage PHBs on behalf of clients, that is the limitation of my role. The assessment, care planning and sign off process, I’m all over it, but I don’t have the time and financial expertise to manage the package itself post sign-off. I do stay involved however to support with reviews, as mentioned.
The usual fee charged for this service is £25 per hour (this has been commissioned by other CCGs at that rate), but there is some room for negotiation if there is an evidence base supporting a reduced rate. I undertake this on a self-employed basis, so I do not have a company number. I invoice monthly for payment due within 30 calendar days.
My Experience and Qualifications:
I have a qualification in safeguarding vulnerable adults and a Level 2 Certificate in Independent Advocacy.
I am also a beneficiary of a Personal Health Budget myself (two actually), the second time almost completely building the package myself, performing the brokerage role myself. I have also, over the last 6 years, worked with many PHB and CHC (and indeed social care) clients supporting them with their care packages, complaints, letter-writing, care planning, peer advocacy and more, in a voluntary capacity, but now offer this as a paid service.
Furthermore, I work closely with the NHS and NHS England around Personal Health Budgets (in a voluntary capacity, albeit paid a recognition fee for attending meetings and a speaker fee for speeches), including sitting on NHS England committees and working with regional PHB leads, so travel all over the country delivering speeches, training, supporting CCGs, supporting events, and assisting organisations such as hospices to embrace PHBs.