Personal Health Budgets in Wales: A Family’s Guide to Choice and Control

A Personal Health Budget lets you have a say in how NHS money for your relative's care is spent, so the care fits the life they actually lead rather than a standard package decided for you. In Wales it usually comes up alongside NHS Continuing Healthcare, and one of the routes it can take is a Direct Payment: the money paid to you or your relative so you can arrange and employ your own care team.

This is a companion piece to our guide on NHS Continuing Healthcare funding. That article explains how the funding is agreed. This one is about what you can do with it once it is.

What a Personal Health Budget actually is

A Personal Health Budget is an amount of NHS money agreed to meet someone's assessed health and wellbeing needs. Rather than being handed a standard package, you work with the health board to write a care and support plan that says what matters to your relative, and then the budget is arranged to deliver it.

It is not extra money, and it is not a loan. The funding for care is simply organised in a more personal way, so that the plan follows the person rather than the person fitting the plan.

Who might be eligible

Let's be honest here, because it matters. Eligibility isn't something we, or anyone, can promise you from the outside. It is decided through an assessment carried out by your local health board.

Personal Health Budgets in Wales most often come up alongside NHS Continuing Healthcare, which is fully funded NHS care for people with significant, ongoing health needs. If your relative qualifies for that, a more personalised way of arranging the care may be part of the conversation. Availability can vary between health boards, so the honest answer to "can we have one?" is that it depends on the assessment, and it is worth asking.

How the money can be used

The point of a budget is flexibility, within the plan that has been agreed. Broadly, it should be used to meet the health and wellbeing needs set out in that plan, in a way that suits the person.

For many families the most powerful part is that a budget can be used to arrange care at home, on your terms, rather than slotting into whatever happens to be available. Where the budget is taken as a Direct Payment, you receive the funding and become the employer of the care team. The Welsh Government's guidance on Direct Payments for Continuing NHS Healthcare sets out how that works, and the rules were updated when the National Health Service (Direct Payments) (Wales) Regulations 2026 came into force on 25 March 2026. That is exactly where our model comes in.

How the HCD Model fits

Most home care works one way. An agency sends whoever is free, and the rota changes week to week. The HCD Model turns that around: you choose your team.

You (or your relative) pick the people who will do the caring, very often someone already known and trusted in your own community. A neighbour. A friend of the family. Someone who already understands the person, the household and the little things that make a hard day easier.

We then employ those people properly, on permanent contracts with holiday pay, sick pay and a pension, not zero-hours. They are trained to CIW standards, and where the care is clinical, our nurses train the team, formally assess their competency and stay involved. Your chosen carer is never the most qualified person responsible for a clinical decision. There is always a nursing team behind them.

A Personal Health Budget and the HCD Model fit together naturally. The budget is the route to choice and control. The model is how that choice becomes a real, stable team around your relative. You can read more about why that matters in local people supporting local people, and about how we manage clinical care safely in supporting complex needs at home.

Where to start

You don't need to have it all worked out before you speak to anyone. Most families come to us with more questions than answers, and that is completely normal.

A good first step is simply to understand where you stand, what an assessment might look at, and what would actually be possible for your relative. Our guide on choosing home care and the first conversation walks through what to expect.

If you'd like to talk it through, book a free, no-obligation conversation with us via our contact form or call 0345 061 9000. There's no pressure and no jargon, just a straight answer to where you stand and what your choices are.