Intended for healthcare professionals


Understanding personal health budgets

BMJ 2020; 368 doi: (Published 03 February 2020) Cite this as: BMJ 2020;368:m324

Linked Opinion

Personal health budgets—a view from the other side

  1. Michael Anderson, research officer1,
  2. Anita Charlesworth, director of research and economics23,
  3. Elias Mossialos, head of department14
  1. 1Department of Health Policy, London School of Economics and Political Science, London, UK
  2. 2Health Foundation, London, UK
  3. 3Health Services Management Centre, University of Birmingham, Birmingham, UK
  4. 4Institute of Global Health Innovation, Imperial College London, London, UK
  5. Correspondence to: M Anderson

Planned expansion should wait for better evidence on the benefits and risks

NHS England sees personal health budgets as an integral part of its long term plan and efforts to personalise care.1 Despite a lack of understanding regarding who is holding personal health budgets and their effect, a national expansion is under way. Personal budgets enable holders to purchase services of their choosing to achieve a person’s health and wellbeing goals. They are typically positioned as a lever to improve patient empowerment, promote competition between providers, and reduce healthcare costs.

Multiple arrangements exist: the budgets can be held by individuals, carers, or third parties such as a charity or social enterprise. They can be funded exclusively by the NHS or jointly with local authorities.2 Since 2014, all adults and children eligible for long term care funded by the NHS have had the right to apply for a personal health budget, and from 2019 it became the default mechanism to pay …

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