Some direct payment recipients are eligible for health funding that can be delivered via personal health budgets. Where the person receives both a personal health budget and council direct payments, they may wish to use the money as a single total sum, to meet their eligible needs for both health and social care and support. In such circumstances, both finance and operational staff in councils will need to be aware of this and work with health and the person in receipt of direct payments and personal health budgets, to ensure the funding can be used effectively and efficiently, to achieve the person’s outcomes.
Some direct payment recipients are eligible for health funding that can be delivered via personal health budgets. Where the person receives both a personal health budget and council direct payments, they may wish to use the money as a single total sum, to meet their eligible needs for both health and social care and support. In such circumstances, both finance and operational staff in councils will need to be aware of this and work with health and the person in receipt of direct payments and personal health budgets, to ensure the funding can be used effectively and efficiently, to achieve the person’s outcomes.
Finance and audit staff and managers
Finance and audit staff and managers have a role in overseeing and facilitating the financial aspects to ensure compliance, accountability, and proper use of funds.
- Collaboration with the NHS. Council finance and audit staff should work in partnership with NHS bodies to ensure seamless processing and management of direct payments and personal health budgets. This may include two separate processes or a single process, run jointly on behalf of both the council and the NHS.
- Set-Up and Processing. Council finance and audit staff or direct payment support services should assist in setting up the financial arrangements, including processing payments, setting up bank accounts if needed, and ensuring that people understand their contracts and obligations, including audit requirements, when using both council direct payments and personal health budgets.
- Safeguarding and Fraud Prevention. Council finance and audit staff should implement and maintain systems to safeguard against the misuse of funds, fraud, or financial abuse. This includes checks and audits to verify appropriate use and alignment with healthcare outcomes.
- Compliance with the CHC Framework. If a person becomes eligible for NHS Continuing healthcare, council finance and audit staff or direct payment support services should ensure that there is a smooth transition to NHS processes, which will need to conform to the statutory guidelines outlined in the CHC National Framework.
Where a direct payment is made by an adult for whom payments are made under 12a (health care/NHS Act 2006), the local authority should take reasonable steps to coordinate the systems process and requirements which it applies or imposes in relation to the direct payment with a view to minimising the administrative or other burdens which they place on the adult for whom the or the nominated person to whom the LA makes the direct payment.
Principal Social Workers
Adult PSWs can play an important role in promoting direct payments alongside personal health budgets. As practice leaders, they should offer support to social work practitioners to consider the following matters:
- Collaboration and Coordination. PSWs should ensure effective collaboration between social care and healthcare services. This includes working closely with NHS teams to facilitate a coordinated approach to care and support planning and the use of personal health budgets.
- Advocacy for Person-Centred Care. PSWs should champion a person-centred approach to care, ensuring that personal health budgets are used to meet the unique needs and preferences of people with health care support needs. This involves ensuring that personal health budgets empower people to make choices about their healthcare alongside their social care outcomes.
- Guidance and Support for Social Work practitioners. PSWs should provide leadership and guidance to social work practitioners on how to navigate the complexities of personal health budgets and their administration alongside council direct payments. PSWs should offer support in understanding health eligibility criteria, assessment processes, and care and supportplanning to ensure social work practitioners are equipped to support people effectively.
- Policy Implementation and Compliance. PSWs have a role in ensuring that local policies and procedures related to direct payments, when running alongside personal health budgets, comply with national guidelines and regulatory requirements.
- Supporting People’s Capacity and Decision-Making. For those eligible for personal health budgets PSWs should promote practices that uphold people’s autonomy and supported decision-making.
- Training and Development. PSWs should ensure that social work practitioners involved in supporting direct payments are well-trained, knowledgeable about personal health budgets and aware of best practices in supporting people with complex health and care needs.
- Safeguarding and Risk Management. PSWs should ensure that safeguarding measures are in place to protect people from exploitation or abuse, including when direct payments run alongside personal health budgets.
- Liaison with Stakeholders. PSWs should encourage communication and collaboration between people, families, carers, NHS practitioners and social care teams to ensure that all aspects of a person’s care are addressed consistently and comprehensively.
PSWs should ensure that social work practitioners understand and apply all relevant legal frameworks correctly, balancing personalisation, autonomy, and safeguarding.
Where a direct payment is made by an adult for whom payments are made under 12a (health care/NHS Act 2006), the local authority should take reasonable steps to coordinate the systems process and requirements which it applies or imposes in relation to the direct payment with a view to minimising the administrative or other burdens which they place on the adult for whom the or the nominated person to whom the LA makes the direct payment.