Direct payments

A personal budget is money from the local authority or NHS to pay for your care and support.

Personal budgets for adults, children and carers

Direct payments are where you receive that money. You manage the money but can get support from your local authority if needed.

Someone to manage your direct payments

Managing a personal budget means you might:

• work out what the money is spent on and how much you have left
• keep copies of receipts
• record what the money is spent on
• advertise, interview and hire personal assistants
• fill out timesheets and pay wages

If you cannot manage a personal budget, you can authorise someone to manage it for you. This may be a family member or friend. They can help with it all, or parts of it.

Your PA cannot manage your budget.

The authorised person can get support in managing direct payments from the local authority.

Support hiring and managing PA payroll 

If direct payments are for a child, a parent will manage the payments.

If you’re aged 16 or over, you can choose to manage your own payments.

If you live in England

There are 5 types of personal budgets. They all do the same thing but are for different situations.

• personal budget for disabled adults or children with social care needs
• personal health budget for disabled adults or children with health needs and continuing healthcare
• carer’s personal budget for unpaid carers
• personal wheelchair budget for disabled adults or children
• personal budget for Education and Health Care Plan (EHCP) for disabled children and young adults with an EHCP

You can receive more than 1 type of personal budget at once.

Each type of personal budget has different eligibility criteria.

If you live in Wales

The application process is different in Wales.

What are direct payments? (Social Care Wales)

You can apply for direct payments through social care services. It might be called self-directed support.

Find your social care services (NHS 111 Wales)

When you have a personal budget, you decide who will manage the money.

Personal budgets and direct payments (NHS)

You can ask your local authority to:

• manage the budget for you
• give the money to another organisation, such as a care agency or charity
• give the money to you (direct payments)

You can manage your personal budget in different ways. This is known as a mixed package.

With direct payments, you have control over:

• who provides your care
• who to recruit as your PA

It takes time and effort to organise your support.

You must keep all receipts and other financial documents to show how you spend your personal budget.

If you employ a personal assistant, you:

• have the responsibilities of an employer
• need to arrange back-up support if your regular PA is ill or on holiday

When you have your assessment for a personal budget, this says what your needs are.

You and the assessor will talk about your needs and agree what should be in your care and support plan.

Care and support plan (NHS)

You must use direct payments for things agreed in your care and support plan.

These may include:

• care agency support
• support at work or in education
• help eating or preparing meals
• club memberships, such as gyms or social groups
• leisure activities and short breaks
• hiring a personal assistant
• disability equipment that meets a social care need

These may not include:

• permanent residential care
• services that your local authority already provides
• food
• household bills
• private medical appointments
• gambling
• illegal goods or activities

If there is something you need that is not on your care and support plan, ask for a review.

Direct payment review

If your social worker or assessor has not allowed you to use your direct payments for something you need, ask for a review. Ask them to add it to your care and support plan.

If there is a cheaper alternative, social care might fund the amount for the cheapest option that meets your needs. If social care has given you a cheaper option that does not meet your needs, you can ask for a review.

If you do not agree with the decision, follow the complaints procedure.

Challenging or complaining about your social care

Depending on who is funding your personal budget, this would be your local council or the NHS’s complaints procedure

When you have direct payments, the money goes to:

• a separate bank account that you set up
• or a supported bank account managed by an agency
• or a pre-paid card for you to use

If you have to contribute something towards your care, your money will go into the same bank account.

The funder pays an agreed amount of money into the bank account every 4 weeks. You also pay your contribution every 4 weeks. This is normally by direct debit or standing order. Ask your local council for details.

Most people use their direct payments to employ a personal assistant (PA).

This means you become an employer, but there is support available.

Support hiring and managing PA payroll

Direct payments will cover the hours of support on your care and support plan. There will also be money to cover your PA’s:

• employer insurance
• National Insurance contributions
• pension contributions
• annual leave entitlement
• payroll services (if this is part of your care and support plan)

If your personal budget funds your PA, you might need to contribute something toward your care. You have a financial assessment to decide the amount.

Financial support for your care

Most of the time, you have to pay for your personal assistant’s travel. They would pay for travel to and from your address. But you would pay for:

• bus or train travel when they are supporting you
• mileage if they drive you somewhere

If travel is to meet a need that is on your care and support plan, it might be included. It would have to be in your care and support plan that direct payment includes travel costs.

Other costs can include:

• a hotel room if you’re staying away from home
• food costs if they are supporting you during a trip away
• tickets to an event you are going to

The direct payment is money for a personal assistant to support you, rather than their travel expenses or other costs while they are working.

How you can save money

You can save money by:

• having a bus pass or railcard
• asking the event if they offer free or discounted carer’s tickets

Disability discounts for days out and travel

Support is available for hiring and managing a PA payroll.

Your local council and the NHS will refer you to organisations they have approved. This support will be part of your direct payment funding and will not cost you more money.

You can choose to get support from other organisations, but you might have to pay for this.

Friends and family can manage your budget

You do not have to manage a direct payment budget and PA payroll by yourself. You can nominate someone else to do this on your behalf. This can include a:

• friend
• family member  

They would be able to see:

• how much money is in your budget
• how many PA hours you have
• personal information about your PAs

Payroll

The council refers most people to their payroll service. This means an organisation that your local council pays will process the PA payroll and work out all the calculations.

If you do not have a payroll service, you would need to work this out or hire someone to do it for you.

If you’d like your council to do your payroll, ask them to add it to your care and support plan.

Most personal budgets are not means-tested. You do not pay towards: 

• personal health budget
• carer’s personal budget
• personal wheelchair budget
• personal budget for EHCP

Many people will apply for a social care personal budget. This is means-tested. You can ask for a personal budget if you:

• are disabled and have 2 or more unmet outcomes or needs
• have less than £23,250 in savings and other assets

If you have more than £23,250 in savings and other assets, you do not qualify for a social care personal budget. You would need to fund your own care.

If you go below £23,250 in savings and other assets, you can then apply for social care support.

Paying for your own care (self-funding) (NHS)

Organisations that can help if you’re self-funding

Financial assessment for adults

Most adults will contribute something towards the cost of their personal budget. This is decided with a financial assessment.

Financial assessment for social care

You can prepare for a financial assessment by gathering evidence and looking at your disability-related expenses.

Preparing for a financial assessment

Some benefits and State Pension count as income for a financial assessment.

Income and benefits for a financial assessment

After the financial assessment, you will receive a letter that will tell you how much you will be charged weekly for your care.

If you agree with their decision, you will pay a direct debit every 4 weeks.

Financial assessment for children

If your child needs direct payments, you will manage the budget. You do not have a financial assessment and you do not pay anything towards their care.

If you are aged 16 or 17, you can:

• manage the direct payments or
• choose to have someone else manage it for you

You will have a financial assessment, it will look at any money you have, but it is rare you would pay towards your care.

Benefits and other financial support

You might be able to claim benefits.

Benefits and other ways of funding the extra costs of being disabled

There are places where you can get free or cheap food. 

Free food and food banks 

If you need support with energy bills, there is some support available from government and local authorities.

Government help with energy bills

Contact Scope to arrange an appointment if you would like free phone or email support.

Contact Scope’s Disability Energy Support

Help with bills and the cost of living

Your local authority or the NHS will review your direct payments after the first 6 months, and then every 12 months.

You can ask for a review if:

• your needs have changed
• your personal budget is paying for an unsuitable placement, like a day centre that you are no longer using.
• you need to spend direct payments on things that are not in your care plan

Getting a review will depend on which personal budget you have.

• For a personal budget review, ask your local council.
• For a personal health budget review, ask your local integrated care board (ICB).
• For a carer’s personal budget review, ask your local council.
• For a personal wheelchair budget review, ask your GP for a referral to wheelchair services.
• For a personal budget for EHCP, ask your local council for an early EHCP review.

If you’re self-funding your care, you would pay for support with hiring and managing payroll.

Paying for your own care (self-funding) (NHS)

Some organisations who can help with payroll include:

• Disability Focus
• Skills for Care
• People Plus
• LiveYou (for young adults)
• NHS Homecare Services
• UK Homecare Association

Call the personal budgets helpline (Disability Rights UK)

Search for local organisations (Advicelocal)

Your local council can signpost you to organisations for free, even if you’re funding your own care.