Individual health budgets have been a “hot topic” for some time now. Recent developments in this area mean that it is a subject to which PCTs need to remain alert.

The Health Bill sets out the possibility of direct payments (payments direct to the patient) and mentions two other routes – a notional health budget (held and allocated by the PCT) and a payment to a third party, such as a user independent trust.

The Department of Health has now invited expressions of interest from PCTs, particularly in partnership with local authorities, to take part in a new pilot scheme following the publication of Personal health budgets: first steps (the guidance). The pilot study was first announced by Lord Darzi last year in his report High quality care for all.

As the guidance indicates, there are already some examples of personal health budgets – within local authorities and education – but also within the NHS, although they are few and far between. The guide includes one example of a user independent trust, namely the arrangements established by South Staffs PCT for Rachel Gunter, who has highly complex impairments and needs 24 hour nursing care.

It is interesting to note that there are already two ongoing cases where patients have sought to judicially review their respective PCTs in a bid to be given the right to fund their own healthcare instead of receiving treatment on the NHS. Steven Harrison and Valerie Garnham, two disabled litigants, have argued that the NHS’s refusal to comply with their wishes amounts to discrimination and a violation of their right for respect for their private lives. The case is ongoing at the time of writing this note and it is likely, given the recent developments, that the judgment will be reserved. We will report on further developments as and when they happen.

The closing date for expressions of interest in the pilot scheme is 27 March 2009. Further information can be accessed here.