One off Personal Health Budgets

What are One-Off Personal Health Budgets?

Whilst there is not a legal right to have a one-off Personal Health Budget, they can complement the legal right to a PHB and also support people who may not meet the criteria for an ongoing budget but still need some extra help at a specific point in time.

One-off PHBs are usually short-term and time-limited. They are often used to help people stay safe, well and healthy, either by avoiding a hospital admission or by supporting someone to leave hospital earlier and more safely.

Unlike ongoing PHBs, which are linked to a legal entitlement and longer-term health needs, one-off PHBs are used more flexibly. They focus on what will make the biggest difference right now, based on the individual’s circumstances, strengths and priorities.

One-off PHBs can support the wider determinants of health, such as:

practical support at home
short-term care or assistance
equipment or adaptations
community, social or wellbeing support
culturally appropriate or personalised solutions

They can be particularly helpful where:

statutory services may be delayed
service thresholds are not met
traditional pathways do not fit the person’s needs
a small amount of timely support could prevent a crisis

Crucially, one-off PHBs are about personalisation and co-production. Decisions should be made with the person, not for them, focusing on what matters most and what will genuinely help them at that moment.

Used well, one-off PHBs can bridge gaps in the system, reduce pressure on services, and support people to remain independent, connected and in control of their health and wellbeing.

How can Co-Production & Me help?

One-off Personal Health Budgets work best when they are supported properly, not just funded.

Co-production and Me provides a level of support package that wraps around one-off PHBs, helping systems turn a short-term budget into personalised, safe and effective support that meets real needs at the right time.

Turning funding into personalised support

One-off PHBs are most effective when funding decisions are linked to co-produced conversations, clear purpose and timely action. This support package helps services move from allocating money to creating meaningful, person-led support that reflects individual circumstances and priorities.

The support package helps services to:

Identify when and how one-off PHBs can be used
Co-produce support with the person, based on what matters to them
Use third-party or notional budget approaches so individuals are not left managing complex processes alone
Put support in place quickly, particularly where statutory services are delayed or thresholds are not met

This enables one-off PHBs to help people stay safe, avoid hospital admission, or leave hospital earlier with the right support in place.

Supporting wider personalised care

Health and wellbeing are shaped by more than clinical interventions alone. One-off PHBs, when used well, can respond to the wider determinants of health and support people in ways that traditional services may struggle to do quickly or flexibly.

Through the support package, one-off PHBs can be used to address:

Housing-related or practical needs
Community connection and social support
Cultural, faith-based or identity-related support
Short-term wellbeing and stability

This allows systems to respond to real-life situations rather than fitting people into services that may not meet their needs.

Designing policies and processes that work

For one-off PHBs to be used confidently and consistently, staff need clear policies, guidance and governance that support proportionate decision-making rather than risk avoidance. Co-production and Me works with organisations to design approaches that are safe, inclusive and workable in practice.

This includes supporting organisations to develop:

Clear local policies and guidance for one-off PHBs
Safe and proportionate governance frameworks
Trauma-informed, culturally responsive and neuroinclusive approaches
Practical tools that help staff feel confident using one-off PHBs in day to day practice

Capturing impact and learning

Demonstrating the value of one-off PHBs requires more than tracking spend. Co-production and Me supports systems to capture meaningful data and insight that show what difference the support has made for individuals and services over time.

The support package includes help to:

Capture meaningful data, not just financial information
Combine quantitative data with lived-experience insight
Track outcomes such as avoided admissions, supported discharges and improved wellbeing
Use learning to support ongoing Quality Improvement (QI)

Demonstrating value

When funding is combined with the right support, one-off PHBs can deliver value at individual, service and system level. Co-production and Me helps organisations recognise and evidence these benefits clearly and consistently.

This includes identifying benefits such as:

Financial – better use of resources and reduced reliance on high-cost crisis and inpatient care
People – improved safety, involvement, independence and trust
Systems – reduced pressure on services and more joined-up working across partners

Considering direct payments

In some circumstances, a direct payment approach could also be considered as part of a one-off PHB. This may be appropriate where individuals are confident managing support and where systems are able to provide the necessary oversight.

However, this option has not yet been trialled within this model and would involve a different level of organisational risk. Any use of direct payments would require clear governance, proportionate risk assessment, agreed safeguards and confidence that the approach is safe and appropriate for the individual.

For this reason, Co-production and Me currently focuses on third-party and notional budget approaches, which enable flexibility and personalisation while reducing risk and administrative burden for both individuals and organisations. Direct payments may be explored in future where systems feel ready and supported to do so.