Your Options Explained
Notional Budget
With a notional budget, the money is held by the NHS and services are commissioned by the NHS according to the agreed personalised care and support plan.
This allows you understanding and input into your budget and it's delivery but ultimately, the NHS remain in control of the money.
This option is the least, in terms of responsibility but also reduces the level of control you have with your PHB.
3rd Party Managed Budget
An organisation independent of the person, the local authority and NHS commissioners manage the budget and are responsible for ensuring the right care is put in place, working in partnership with the person and their family to ensure the agreed outcomes can be achieved. They are particularly helpful when a person:
- does not want to manage a direct payment
- does not wish to take on employer responsibilities for personal assistants
- lacks capacity or is otherwise not in a position to manage their own budget
- needs specialist or very tailored support that most providers are not in a position to deliver.
This option can provide an increased level of control from the Notional Budget but without increasing the level of responsibility. For example this option might work well for you if you need a lot of care and support and will need a large number of staff to support you or you want to stay in control of day-to-day decisions but you do not want the responsibility of employing staff.
Direct Payments
Direct Payments means that the money is paid to a person (or their representative or nominee) funded by the NHS, to allow them to purchase the services that are agreed in the personalised care and support plan.
This option is, in terms of responsibility, very involved, but it means that you have full control of your budget, the delivery of your care and can achieve a more personalised approach to your PHB.
There are varying levels of Direct Payment, including a 'managed account’ which is is the term used when a direct payment is held in an account on behalf of the budget holder, by a direct payment support service, solicitor, accountant or other provider. Unlike a third party budget, the managed account provider does not take on responsibility for arranging care and support, but co-ordinates the financial elements of the budget.
Again, this reduces the level of responsibility but also the control and flexibility you may wish to include in your PHB.
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