Personal Health Budget (PHB) and Continuing Healthcare (CHC)

11mee

Hi everyone, I’m looking for some advice or to hear from others in a similar position .I’m managing a PHB from CHC  for my adult child who has very complex needs. I am very grateful to receive the funding as our situation prior was desperate but I am finding the administration and lack of support from the CHC team and the budget-holding charity a total nightmare. These are the main issues I am facing :

• The budget stipulates  majority Self Employed PA hours and a few PAYE PA hours a week . The charity (chosen by the  CHC team ) managing our payroll only handles the PAYE PAs. The CHC team informed me that the self-employed PAs should provide their own contracts, but I have no idea who is supposed to vet these or check if they are legally sound. I’m worried about the liability.
• Due to the ICB setting the Self employed PA hourly rates so low , The PAs argue that because the rate barely coves their costs/tax, they are actually better off being PAYE employees.
• I  received the budget for last year and despite it being a large allocation and never fully using it on a weekly basis ,  the charity often tells me there are "no hours left" when I try to claim for extra support.
•  I was under the impression that unused hours (like when the PAs do not work over Christmas) would carry over, but they seem to just "disappear." I’m currently personally subsidising the budget just to make the care plan work, which feels wrong.
• My staff are often paid late because the charity and the CHC team don't communicate. I don’t seem to have a contact from CHC since the budget was put in place . This is causing staff to leave, me a lot of stress ,  which is devastating for my child’s stability.

Has anyone else dealt with this kind of gatekeeping from a budget holder?  and should the CHC team be providing more support with the legal side of PA contracts?Any advice on how to handle this, or which organisations I should contact to help me advocate for my child, would be massively appreciated. Thank you!

beanielou

I have a PA who is paid through direct payments from my local authority. I have to use a payroll company appointed by them for payroll. The payroll is run monthly. The LA supply the contract.
I know it is very difficult to recruit to PA’s to be paid through direct payments as the rate is so low.
Sorry to be unable to directly answer your questions but just giving you an overview of how it can work.

bribri_2

Have you chosen to have a PHB rather than care provided by an agency and directly paid by the ICB?

Which ICB is it?

OldMan73

we found the free checklist on this website useful https://continuinghealthcareguide.co.uk/