The Children’s and Families Act 2014 set out that a local authority (LA) is under a duty to consider a Personal Budget when requested by a parent or young person either:
- Following the completion of an Education, Health and Care (EHC) needs assessment and where the local authority has confirmed that it will produce an Education, Health and Care (EHC) plan
- As part of a statutory review of an existing EHC plan
What is a personal budget?
A personal budget is a part of the EHC plan and is designed to give families choice and control on how the provision in the EHC plan is delivered.
A parent or young person can ask for a personal budget when it has been agreed to produce an EHC plan or as part of an annual review of an existing EHC plan.
As an EHC plan could contain provision from education, health or social care agencies, how your personal budget could be set up will depend on the child / young person’s needs and circumstances which would be explored during the EHC needs assessment.
A personal budget would be described in Section J of an EHC plan, and would link to provision agreed in Sections F (education), G (health) or H (social care) or any combination of these.
Personal budgets can only be used for outcomes identified in an EHC plan. Personal budgets cannot be used to pay for assessments (as part of the EHC needs assessment or in readiness for an annual review) or to cover the cost for fees of a named educational placement.
The LA is under a duty to consider a personal budget but not under a duty to provide one.
How do they work?
A personal budget can be set up in the following ways:
- Direct payment – your budget is paid directly to you or your young person to arrange, buy and manage the support and services for yourselves
- An arrangement (sometimes called a notional budget) – you can ask the LA to look after it. The LA arranges and pays for support and services on your behalf
- Third party arrangements – your budget is paid to an individual or organisation for them to arrange, buy and manage the support and services on your behalf
- Family contribution – you agree to use some of your own money to pay for specific services
- A combination of the above.
If you decide to hold your/your child’s personal budget through a direct payment, you will have to enter into an agreement with the LA to use the money to provide the agreed outcomes, to provide financial monitoring information and to pay back to the LA any unused money.
Where does the money come from?
There is no extra money for personal budgets. A personal budget would be funded by everyone agreeing to use existing resources differently.
- Money used to pay for education services (this could be from your LA or your child’s school / setting) would be used for a personal budget that delivers Section F provision.
- Money from health would be used for a personal budget that delivers Section G provision.
- Money from social care would be used for a personal budget that deliver Section H provision.
Everyone may agree to pool the funding where there are shared outcomes.
If you are under 18, the money for the health and social care provision would come from Children’s health or social care services. If you are over 18, the money will come from Adult’s health and social care services.
To access the money for personal budgets from health or social care, you / your child would need to be eligible to receive a service from:
- Children’s social care: Short breaks and Children with disabilities
- Adult’s social care: Learning disability service, Community teams, Asperger’s service, Mental health social work service. Find out if you are eligible for adult care.
- Health: Children’s continuing care and Adult’s continuing healthcare
I am thinking of asking to hold a personal budget, what would happen?
It’s good to start thinking about whether a personal budget would be right for you when the LA has told you they are going to carry out an EHC needs assessment.
At the start, the EHCP coordinator should be talking to you about which services you already receive or that you think should be involved with you/your child, so we know who to get advice from for the EHC needs assessment. It is very important if you think you should be getting a service from any of those detailed above, that you mention this to your EHCP coordinator so they can tell you how to ask for a service.
The EHC needs assessment, which should include the ‘person-centred planning meeting’ will start to identify needs, outcomes and provision and this will help you to start to think about how you want the personal budget set up ie through a direct payment, an arrangement (notional budget), third party arrangement or a combination of these options.
The EHC needs assessment will identify any personal budget that can be received from social care or health as a direct payment / individual budget and this can be described in the EHC plan if one is agreed.
If you think you would like to receive education provision through a personal budget you will need to tell your EHCP coordinator when you know we will be agreeing an EHC plan. The EHCP coordinator would then need to consider:
- That the service for which the personal budget has been requested is to deliver SEN provision in order to meet needs and achieve the SMART outcomes and that there is documented professional evidence.
- Whether the service is already commissioned by the local authority and if so whether to separate funding for a personal budget would have an adverse impact on services provided by the local authority for other EHC plan holders
- The total cost of the provision described in Section F of the EHC plan and whether the funding for the personal budget is already committed within delegated funding arrangements to schools or colleges and to separate funding for a personal budget would place provision to other children/young people at risk
- Whether agreeing provision through a personal budget would be an efficient use of the local authority’s resources
The EHCP coordinator would then need to:
- Liaise with the school / setting regarding the funding arrangements
- Talk to you about the responsibilities of having a direct payment and the agreement you would need to enter into
- Get the written agreement of the head teacher of the child’s school or setting for any provision that is funded through a direct payment to be delivered on their premises.
The LA will take a decision about whether to provide a personal budget through a direct payment and you would be informed.
If it is agreed to let you hold a personal budget
If a personal budget is agreed, it will be described in Section J of the EHC plan.
If the LA does not agree to a personal budget
The LA must inform you in writing, setting out its reasons, before the draft EHC plan is issued. It is important to note that you cannot appeal because the local authority has refused to provide a personal budget.
If the provision that the personal budget was identified for is still described in the EHC plan, it means that you / your child will still receive that support. If the provision isn’t described or it is described differently and you are unhappy about any of this, you can appeal.
I am thinking about a pooled personal budget, what would happen?
The exciting thing about an EHC plan is the potential to pool funding between education, health and social care.
Pooling a budget may offer real benefits to particular children or young people. The opportunity to pool budgets will only come if you are / your child is eligible for a service from health or social care as described above. This is likely to only be available for children and young people with the most complex needs.
Here is an example of how a pooled budget might work:
A child attends a local special school and has a range of complex physical and medical needs, sensory impairment and severe learning difficulties.
The family receive a personal budget from health under Continuing Care which they use for nursing care within the home. The family also receives a personal budget from LA social care to fund a personal assistant to support the child to access short breaks and social activities. The child receives home to school transport which includes a personal travel assistant to tend to the care needs whilst travelling and the school is funded directly by the LA and provides a trained teaching assistant to provide care to the child whilst in school.
The child therefore has four different individuals all delivering support to meet their complex learning difficulties and disabilities and broadly carrying out similar roles at different times of the day.
The family wish to access a personal budget via the EHC plan in order to employ one holistic support assistant who will deliver all of this provision to meet the child’s needs and achieve outcomes across the education, health and care elements of the EHC plan. The EHC plan with its approach to joining up support across all elements of the EHC system provides a way to do this.
The cost of employing the support assistant is estimated together between the LA and the family to provide an indicative sum. The family agree to pool their social care and health budget and the school agrees for the LA to release the funding from the child’s top up funding to contribute to the personal budget. The family chooses to receive the funding for a direct payment and the school agrees that the assistant can deliver provision from within their premises. The arrangements are finalised at the transfer review of the child’s statement to an EHC plan.
Such an arrangement would require all responsible commissioning bodies (the LA for education and social care provision and CCGs or NHS England in the case of health provision) to agree to the pooling of the personal budget and each would need to be assured that any regulatory requirements are met.
If a pooled budget is something that you think you would like to explore, you need to talk to your EHCP coordinator as soon as possible in the EHC needs assessment and plan development process, because this will take time to set up.