How can Personal Health Budgets help people at the end of their life?

24 February 2017 | By Amanda George

Jo talks about the work she has been doing with Independent Lives and NHS Horsham & Mid Sussex to help people to have choice and control as they approach the end of their life.

Over the years, we’ve done lots of work to help people to have conversations, think and plan for the end of their life. It’s a highly emotional subject, but one that’s really important to us. We’ve seen the difference that person-centred approaches can make at this time, and hope that through initiatives like Living Well, we hope that we’re making an impact.


Recently I’ve been working on end of life care again, but in a different way. This time, we’re looking at how Personal Health Budgets can give people more choice and control over how they want the end of their life to look like. Bringing this together with our experience using person-centred approaches feels like an important step forward. Not only are we helping people think through important decisions, but through the PHB itself we are giving them the financial capacity to create the change they want to see.

The story so far

Michelle facilitated the launch conference for this work, and since then, I’ve been working to co-design and deliver training for facilitators who will be developing care and support plans for people involved in the pilot.

The project is working with people who have a terminal diagnosis and are entering the last year of their lives. Some other pilot sites are working with people who are already in the last three months of their life, but I am happy that we are able to take a longer-term view. Although it means people don’t necessarily have a PHB at the moment, they are able to explore the possible ways that they might use it when it becomes available. It gives them more time to think, and to plan really well.

What's next

People haven’t yet started to create their care and support plans just yet, but our facilitators are now ready to start that soon. I’ve been training them around a few key approaches that we’ve used in end of life settings before, including:

We are also including the approaches that Max Neill, our good friend and co-founder of Community Circles, developed and used at the end of his own life; around legacy instructions and end of life wishes. You can read more about some of these on Helen’s blog.

What I'm hoping for

Well, I’m hoping that people will feel in control and empowered about the final stage of their lives. It’s a big ask, but from our experience, supporting people to have the right conversations can go a long way to making this happen. Together, I hope we’ll be able to help people to have peace of mind in the last stage of their lives.

If you’d like to know more about Personal Health Budgets at the end of life, just get in touch with me via I’m happy to share our learning, or to design training to suit your needs.

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