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Description
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Enables a Patient/Service User to set up and manage a Personal Health Budget giving them more choice and control over the management of their identified healthcare and well-being needs. |
Personal Health Budgets are amounts of money allocated to a Patient/Service User to support their health and well-being needs and to enable them to purchase and manage their own treatments, equipment and personal care. Personal Health Budgets are available to Adults receiving NHS Continuing Healthcare and children receiving continuing care - for example, people with long-term physical or mental health issues. Requests outside this are considered on a case basis by the Patient/Service User's CCG.
A Personal Health Budget Capability will allow a Personal Health Budget to be defined, reviewed and updated. The Capability facilitates the link between the Personal Health Budget and the Patient/Service User's care plan to ensure spend is directed towards meeting the Patient/Service User's health goals. A Personal Health Budget Capability will allow purchases of a range of products and services to deliver the agreed health and well-being outcomes, for example therapies (e.g. counselling), personal care (e.g. a personal assistant), services (e.g. gym membership) and equipment (e.g. a wheelchair). CCGs will be able to assess Personal Health Budgets to ensure they are used appropriately.
A Personal Health Budget Capability may manage multiple budgets and the directory of equipment, treatments and therapies and give further reporting functionality. It may also link to the Patient record and Workflow tasks to further broaden its integration with other functions.
Outcomes
Patient/Service User |
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Care Coordinator or Local NHS Team member or Health Broker |
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CCG |
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Service Provider |
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C32E1 - manage Personal Health BudgetAs a Patient/Service User I want to manage my Personal Health Budget So that I can use my budget to deliver my desired health outcomes Acceptance criterion 1: create Personal Health BudgetGiven the Health or Care Professional has requested a Personal Health Budget When they choose to create the Personal Health Budget Then the Personal Health Budget is created for the Patient/Service User Acceptance criterion 2: choose an individual to manage Personal Health BudgetGiven the Patient/Service User has been allocated a Personal Health Budget When the Patient/Service User chooses an individual to manage their Personal Health Budget on their behalf Then the individual can access the Personal Health Budget And can make purchases on behalf of the Patient/Service User Acceptance criterion 3: view Personal Health BudgetGiven that the Patient/Service User has a Personal Health Budget And purchases have been entered When the Patient/Service User chooses to view the Personal Health budget Then the Personal Health Budget is displayed Acceptance criterion 4: review Personal Health BudgetGiven a Personal Health Budget and care plan has been set up for a Patient/Service User When the Personal Health Budget is reviewed Then a record of the review can be recorded against the Personal Health Budget Acceptance criterion 5: amend Personal Health BudgetGiven a Personal Health Budget and care plan have been set up for a Patient/Service User When the Personal Health Budget is reviewed Then the Personal Health Budget can be amended Acceptance criterion 6: close Personal Health BudgetGiven a Personal Health Budget and care plan have been set up for a Patient/Service User When the Personal Health Budget is reviewed Then a record of the review can be captured against the Personal Health Budget And the Personal Health Budget can be closed or made inactive C32E2 - record Personal Health Budget purchasesAs a Patient/Service User I want to be able to record Personal Health Budget purchases So that I can evidence where my Personal Health Budget has been spent Acceptance criterion 1: record Personal Health Budget purchaseGiven that the Patient/Service User can access the Personal Health Budget Solution When payment is made for products or services (by the NHS team, a Third party or the Patient/Service User) Then evidence of how and on what the money has been spent (e.g. receipts, invoices, bank statements) can be captured And this is recorded against the Personal Health Budget for the Patient/Service User C32E3 - assess Personal Health BudgetsAs a representative of the CCG I want to be able to assess Personal Health Budgets So that I can ensure that Budgets are only spent on appropriate products and services Acceptance criterion 1: view purchase trail against the budgetGiven the user has been permitted access to the Personal Health Budget And the Personal Health Budget purchase has been recorded When the user chooses to view the purchase trail against the budget Then purchase trail against the budget is displayed |
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C32E4 - link Personal Health Budget with care planAs a Patient/Service User I want to link my care plan and Personal Health Budget So that I can ensure that my Personal Health Budget is spent in the way most likely to deliver my identified health and well-being outcomes Acceptance criterion 1: link Personal Health Budget with care planGiven a care plan has been created for a Patient/Service User When the Personal Health Budget is created Then the Budget and care plan for the Patient/Service User can be linked And the care plan can be viewed Acceptance criterion 2: link Purchases to elements on the care planGiven a Personal Health Budget has been created for a Patient/Service User And a care plan has been linked When items of spend are identified for purchase against the Personal Health Budget Then the purchases can be linked to elements of the care plan C32E5 - support different models for management of Personal Health BudgetsAs a Care Coordinator or Local NHS Team I want to choose a model to manage a particular Personal Health Budget So that I can select the model that will be most appropriate and effective for the Patient/Service User and their Care Team Acceptance criterion 1: support different management modelsGiven a Personal Health Budget has been assigned to a Patient/Service User When the model to manage Personal Health Budgets is chosen (e.g. via the NHS Care Team, Third Party, direct payment or a combination of these) Then different elements of the Budget can be assigned to the relevant model And the agreed equipment, treatments or services can be purchased by the relevant individual or Third Party C32E6 - apply criteria for the use of Personal Health BudgetsAs a representative of the CCG I want to apply criteria for the use of Personal Health Budgets So that I can ensure the Budgets are used only by eligible Patients/Service Users Acceptance criterion 1: eligible Patient/Service UserGiven the Personal Health Budget eligibility criteria has been defined for Patients/Service Users (e.g. Adults eligible for NHS Continuing Healthcare and children receiving continuing care) When the Patient/Service User is identified as eligible for a Personal Health Budget Then the Personal Health Budget can be created for the Patient/Service User C32E7 - payments under Personal Health BudgetsAs a Health or Care Professional I want to make payments relating to Personal Health Budgets So that I can enable Patient/Service Users to access appropriate products and services Acceptance criterion 1: pay for products or servicesGiven a Personal Health Budget is being managed with a model (e.g. via the NHS Care Team, Third Party, direct payment or a combination of these) When the user chooses to make a payment for a product or service Then a payment can be made And the payment can be recorded against the relevant Personal Health Budget C32E8 - maintain directory of equipment, treatments and servicesAs a Personal Health Budget Manager or Health or Care Professional I want to be able to maintain a directory of equipment, treatments or services So that I can use the directory to find relevant equipment, treatments or services Acceptance criterion 1: create directory of equipment, treatments and servicesGiven that the user is permitted to create a directory of equipment, treatments and services in the Personal Health Budget Solution When the user chooses to create the directory of equipment, treatments and services in the Personal Health Budget Solution Then the directory is created Acceptance criterion 2: view directory of equipment, treatments and servicesGiven that the user is permitted to view the directory of equipment, treatments and services in the Personal Health Budget Solution And the directory of equipment, treatments and services has been created in the Personal Health Budget Solution When the user chooses to view the directory of equipment, treatments and services in the Personal Health Budget Solution Then the directory is displayed Acceptance criterion 3: amend directory of equipment, treatments and servicesGiven that a directory of equipment, treatments and services has been created in the Personal Health Budget Solution When the user chooses to update the directory of equipment, treatments and services in the Personal Health Budget Solution Then the directory is amended Acceptance criterion 4: remove an item from the directory of equipment, treatments and servicesGiven that a directory of equipment, treatments and services has been created in the Personal Health Budget Solution When the user chooses to remove an item from the directory of equipment, treatments and services in the Personal Health Budget Solution Then then the item in the directory is removed C32E9 - search a directory of equipment, treatments and servicesAs a Personal Health Budget Manager or Health or Care Professional I want to be able to search a directory of equipment, treatments or services So that I can identify and select the equipment, treatments or services that will support delivery of the Patient/Service User's healthcare outcomes Acceptance criterion 1: search directory of equipment, treatments and servicesGiven that a directory of equipment, treatments and services has been created in the Personal Health Budget Solution And search criteria have been defined When the user chooses to search for equipment, treatment or services Then the list of equipment, treatments or services that match the search criteria are displayed C32E10 - manage multiple budgetsAs a Personal Health Budget Manager I want to manage budgets from multiple sources (e.g. those relating to health, care, education or other needs) as a single, joint budget So that I can more easily manage and co-ordinate across all my needs Acceptance criterion 1: manage multiple health and care budgetsGiven a Personal Health Budget has been set up for a Patient/Service User And the Patient/Service User holds further budgets (e.g. a social care Personal Budget) relating to their needs When the Patient/Service User identifies they want to manage these as a joint budget Then the multiple budgets can be managed as a single budget within the Personal Health Budget tool or system And the Patient/Service User can use the single, joint budget to pay for agreed equipment, treatments or services across their health, care, education or other needs C32E11 - link to Patient RecordAs a Health or Care Professional I want to be able to access the Patient Record for the Patient So that I can confirm their medical history and understand their entitlement to a Personal Health Budget Acceptance criterion 1: link to Patient RecordGiven the Health or Care Professional has been permitted access to the Patient Record When the user chooses to view the Patient Record Then the Patient Record is displayed C32E12 - link to WorkflowAs a Health or Care Professional I want to be able to create a workflow task from the Personal Health Budget Solution So that I can send requests for information into the Patient/Service User's Practice (e.g. request for clinical information, request for confirmation of medical history) Acceptance criterion 1: create Workflow taskGiven the Health or Care Professional has been permitted to create Workflow Tasks When the user chooses to create a Workflow task Then the Workflow task is created And the task is directed into the workflow for the Practice C32E13 - provider viewAs a Service or Product Provider I want to be able to view the purchases of my products or services So that I can analyse and understand take-up of my products and services Acceptance criterion 1: provider can view purchase informationGiven a Provider's products or services are included in the Directory And they are permitted to view information in the Personal Health Budget Solution When they choose to view purchases of their products and services Then purchase information relating to their products or services is displayed C32E14 - Management InformationAs a representative of the CCG I want to analyse and report against data relating to Personal Health Budgets So that I can use the results to plan and commission healthcare more effectively to meet the needs of Patients/Service Users Acceptance criterion 1: Management Information reportingGiven the user is permitted to run Management Information reports When the user chooses to run a Management Information report Then the Management Information report is displayed C32E15 - identify candidates for Personal Health BudgetsAs a representative of the CCG I want to identify potential candidates eligible for Personal Health Budgets So that Patients/Service Users can be proactively identified Acceptance criterion 1: identify Patients/Service Users that are candidates for a Personal Health BudgetGiven the CCG has defined criteria for prioritising Patient/Service User need When the CCG representative inputs the criteria to identify Personal Health Budget candidates Then the results for Patients/Service Users meeting the criteria are displayed |
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Suppliers will have to attain compliance with these Standards during the compliance stage before they can be live on a framework with this Capability: None |
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Suppliers will also have to attain compliance with these additional Standards during the compliance stage before they can be live on a framework with this Capability: |
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Suppliers will not be assessed or assured on these Roadmap Items as part of Onboarding
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