EHC plan personal budgets

What is a personal budget?

A personal budget is a part of an Education, Health and Care (EHC) plan. It is designed to give families choice and control, on how the provision in the EHC plan is delivered.

The Children and Families Act 2014 states that we, as a local authority, are under a duty to consider a personal budget, when requested by a parent or young person. This could be:

• Following the completion of an EHC needs assessment, where we have confirmed we will produce an EHC plan for a child or young person
• As part of a statutory review of an existing EHC plan

Although we are under a duty to consider a personal budget, we are not under a duty to provide one.

What can it be used for?

An EHC plan can contain provision from education, health or social care agencies. Therefore how your personal budget could be set up, will depend on:

• The child or young person's needs 
• The circumstances, which would be explored during the EHC needs assessment

A personal budget would be described in Section J of an EHC plan. It links to provision agreed in Section F (education), Section G (health) or Section 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) 
• To cover the cost for fees of a named educational placement 

How is a personal budget set up?

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 us to look after it. We arrange and pay 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 receive your child's personal budget through a direct payment, you will have to enter into an agreement with us:

• To use the money to provide the agreed outcomes
• To provide financial monitoring information
• To pay us back any unused money

Where does the money come from?

There is no extra money for personal budgets. A personal budget is funded by everyone agreeing to use existing resources differently.

• Money used to pay for education services (this could be from us, the local authority, or your child's school/setting), would be used for a personal budget that delivers Section F (education) provision
• Money from health, would be used for a personal budget that delivers Section G (health) provision
• Money from social care, would be used for a personal budget that delivers Section H (social care) provision

Everyone may agree to pool the funding where there are shared outcomes.

If the young person is under 18-years-old, the money for the health and social care provision will come from children's health or social care services. If the young person is 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, your child would need to be eligible to receive a service from:

• Children's social care: short breaks or children with disabilities team
• Adult's social care: learning disability service, community teams, Asperger's service or mental health social work service
• Health: children's continuing healthcare and adult's continuing healthcare

I am thinking of asking to hold a personal budget. What do I need to do?

It's good to start thinking about whether a personal budget would be right for you, when we tell you we are going to carry out an EHC needs assessment.

At the start of the assessment, an EHC plan coordinator should discuss which services you already receive, and services you think should be involved with you/your child. This is so we know who to get advice from for the EHC needs assessment. It is very important if you think you should be getting help from any of the services detailed above, that you mention this to your EHC plan 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 EHC plan coordinator when you know we will be agreeing an EHC plan. The EHC plan 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 Integrated Care Board (ICB) 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 EHC plan coordinator as soon as possible in the EHC needs assessment and plan development process, because this will take time to set up.