In April 2014 the NHS introduced personal health budgets (PHBs), a pot of money to support an individual patient's goals and needs, both in health and general well-being. All patients eligible for a PHB can influence how their health and well-being needs are met with funding from the NHS. The budget must be approved by a local NHS team and is intended to fund not only therapies but also personal care, aids and equipment.

An investigation by Pulse magazine, a specialist health journal focusing on primary care, calls into question the way in which personal health budgets are being spent. It found that £120m will be spent in the 2015/16 financial year on 4,800 patients. However, the report highlights that PHBs are being used to buy luxuries whose clinical benefit is unproven and far from clear. For example, that patients have received NHS funding for computer games, holidays, horse-riding, music lessons and even to build a summer house. 

While such spending may improve the quality of life for these patients, many will question why the NHS is providing funding for these luxuries at a time when it is struggling to meet the costs of core healthcare and recruiting and retaining clinical staff.

Indeed, the report highlights that there are signs that PHBs are beginning to destabilise local services as money diverted to fund them is leaving some local services short of the steady income streams they need to remain viable. These include the closure of a mental health service run by MIND in Essex after funding was cut by the local commissioning group to fund PHBs. 

Commenting on the report, Andrew Clayton of Penningtons Manches' clinical negligence team explains: "Personal health budgets may be welcome to those enjoying the benefits but the NHS lacks the resources to fund these lifestyle improvements. PHBs were intended to give patients greater flexibility but to be subject to controls to ensure that spending was directed to appropriate services. This report clearly casts doubt over the effectiveness of current controls.

"It is alarming that local health and care services are facing cuts that jeopardise their existence because funding is being diverted to PHBs. Closing these services to the wider population so that a minority of patients can enjoy luxuries at the NHS' expense cannot be acceptable. We need tighter controls urgently to be introduced to ensure that PHBs are targeted to appropriate and clinically proven services."