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A direct payment is cash paid to you to buy your social care support


A direct payment is a cash payment made directly to you so you can buy your own support rather than having it delivered to you by your local authority. The payment must be enough for you to buy services that meet your care needs and the money must be spent on services that meet those needs.

Many people take a direct payment so that they can employ their own personal assistant. There are direct payment support services available to help you manage your direct payment; Penderels Trust is a leading provider of these services.

You will be required to keep a record of how you spend your direct payment and your local authority will want to see those records, usually once a quarter.

Direct payments are available wherever you live in the United Kingdom and are available to adults with disabilities (including those who lack mental capacity), families of children with a disability and carers. A direct payment cannot be used to purchase residential care or services provided directly by a local authority.

Direct payments for people who need social care support have been around for over twenty years, but more recently people with long term health care needs can now receive a direct payment as part of their personal health budget. These are controlled by the Clinical Commissioning Group (NHS) as opposed to the local authority.

The support services offered to direct payment recipients do vary from one local authority area to another. Here are some questions that we are frequently asked about direct payments.

A Personal Health Budget is an amount of money that has been allocated to you to pay for your care for your identified healthcare and wellbeing needs.
At the centre of your personal health budget is your care plan.

This plan helps you decide your health goals together with your local NHS team
You may already get a personal budget to pay for your support from social services and personal health budgets work in a similar way.

The main aim of a personal budget is that you have more choice and control over how the money is being spent to meet your healthcare and wellbeing needs. You will know how much money there is for your healthcare and you will have a say in what treatments and services you have to meet your needs.

At the moment, some areas in England are providing personal health budgets to individuals who are receiving care and support through NHS Continuing Healthcare funding and mental health services. Everyone who is eligible for NHS Continuing Healthcare has the right to have a personal health budget.

There are three different ways a personal health budget can work:

1  - Notional budget

The NHS will tell how much money has been allocated for your care. You tell the NHS how you want the money to be spent and if your local NHS team agrees with your plan, they will arrange the care for you.

2 -  Real budget held by a third party

An independent organisation, such as Penderels Trust, looks after the money for you and helps you to decide how you want to spend it. This organisation is the ‘third party’. If the local NHS agrees with how you want to spend your money, the third party organisation buys the care and support for you.

3 -  Direct payment for healthcare

You will receive the money to buy and manage your own healthcare and support. You have to keep the money in a separate bank account and tell your local NHS team what you are spending the money on. Independent organisations, including Penderels Trust, can support you to manage your direct payment for healthcare.

The amount of money you will receive will depend on the health and wellbeing needs that you have and how much it will cost to meet those needs. No one will have to use their own money to get the NHS care they need.

You can use the budget for most types of healthcare and support but it must be part of your care plan that has been agreed by your local NHS team.

You can use your budget for:

  • Personal care – including employing your own personal assistant or using an agency for your healthcare and wellbeing support.
  • Training or therapy to help you look after your health
  • Equipment to help meet your care needs

One of the main benefits of having a personal health budget is that as long as the services or goods you buy meet your agreed care needs, you can choose what you use the money for and who you buy them from.

  • Emergency health services.
  • Services you would normally get from your doctor.
  • Paying off debts.
  • Alcohol, tobacco or anything illegal.

No. If you are happy with how you are receiving your care now, you don’t have to change anything. If you choose to receive a personal health budget but find it isn’t working for you, you can go back to how you received care before.

Personal health budgets should help people get the best services from the NHS. They should not make things worse for anyone.

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