| Reference | FOI 2025/1329 |
|---|---|
| Description | CHC funding/personal health budget & personal assistants |
| Date Requested | 11/08/2025 |
| Date Replied | 05/09/2025 |
| Category | Continuing Health Care (CHC) |
Please could you send me the following information:
1. Does your ICB allow those with CHC funding/personal health budget to pay their personal assistants to continue providing personal care in hospital settings?
2. Is your policy on this written into the DP agreement? If so, what does it say?
3. Does ICB have a protocol in place regarding Personal Assistants/paid carers assisting with complex care needs in hospital settings? What is it?
4. How many times in the last 3 years has a service user had their care needs met by their usual PAs/paid carers whilst in a hospital setting?
NHS Greater Manchester consists of the following 10 Greater Manchester Localities: Bolton, Bury, Heywood, Middleton and Rochdale, Manchester, Oldham, Salford, Stockport, Tameside, Trafford, and Wigan (former Clinical Commissioning Groups), who currently all have their own processes/systems for recording their Continuing Healthcare (CHC) activity.
1. Yes, however it is for the holder of the PHB, as the employer, to negotiate with the acute trust as the issue is relating to insurance to deliver care on site.
2.
| Bolton | No. The Direct Payment Agreement says the direct payments cannot be used for the following – Primary medical services provided by general practitioners as indicated in the Support Plan; or Urgent or emergency treatment services (including any unplanned hospital admissions); or Planned surgical procedures but does not specify that the personal health budget cannot be used to pay personal assistants to continue providing personal care in hospital settings. |
| Bury | No |
| HMR | Not written in HMR’s policy |
| Manchester | No |
| Oldham | No, as the usual routine care is not provided when in the hospital setting |
| Salford | No |
| Stockport | No |
| Tameside | No |
| Trafford | No |
| Wigan | No |
3.
| Bolton | There is no protocol in place. Clinical/professional judgement is applied on an individual basis when a patient is admitted to hospital as to whether the PA will continue to provide support |
| Bury | Nothing mentioned within the DP agreement. |
| HMR | Not in HMR’s DP agreement |
| Manchester | No, it is not captured within the DP agreement. We do support the individual with a hospital passport however we have no cases where PAs are required to provide complex care for individuals in hospital settings. |
| Oldham | No, but the PAs are only permitted to provide reassurance or emotional support during the acute phase of their illness requiring a hospital admission. The hospital staff are responsible for providing the physical and acute care |
| Salford | Specific roles and responsibilities agreed on a case-by-case basis in line with the assessed needs and the nature of the hospital setting |
| Stockport | No |
| Tameside | No |
| Trafford | No NHS GM have a policy that includes PA’s assisting with complex/delegated healthcare tasks in a person’s home. |
| Wigan | No |
4.
| Bolton | There have been <5 patients who have received support from their PA during a hospital admission in the last 3 years. It is not routinely agreed and is an individual exception. |
| Bury | Bury locality would not routinely agree to care needs being met by their usual PA’s/paid carers whilst a patient is in hospital. We do not hold information as to how many, if any have been agreed within the last 3 years |
| HMR | HMR does not hold this information |
| Manchester | On exceptional cases where the individual has a high level of anxiety or a known learning disability or mental health need. Manchester CHC have agreed for a PA to attend the individual within the hospital setting to provide familiarity or emotional support for the individual. It is estimated there has been an average of several instances when this has occurred however specific numbers are not separately recorded. |
| Oldham | This is not something that is formally recorded in this locality. This is a rare occurrence as the PA’s are commissioned to support when the client is within their optimal condition and not when acutely unwell. The exceptions being if a client with learning disability or mental health needs requires the familiarity of consistent staff to reduce anxiety and distress, but they are there for emotional support only and not to provide the usual level of commissioned support. An estimated number of occurrences would be 5 times within the past 3 years |
| Salford | Care from community care staff and PAs is only continued into the hospital setting under exceptional circumstances where there are needs that could not be met by the staff within the hospital setting. In the last 3 years this has been agreed for <5 individuals on the caseload who have highly complex needs. |
| Stockport | We do not hold information in relation to this question, however we would only consider support in such circumstances to meet the psychological and emotional needs of the individual only. |
| Tameside | This not something that is formally recorded therefore no data can be provided. In response to Q1 the agreement will be based on the individual’s needs such as a ventilated patient being on a general ward or to support some clients if they have communication or emotional needs which require support from a familiar person. |
| Trafford | <5. Trafford locality does not fund clients in a hospital setting. |
| Wigan | Wigan would not routinely agree to care needs being met by their usual PAs/Paid carers whilst the patient is in hospital. However, a request from the hospital would be dealt with on an individual basis. We do not hold information as to how many, if any have been agreed within the last 3 years. |
