North West London PHB Support Service

The first step on your PHB journey is a clinical assessment of your health needs. This is usually completed by a multi-disciplinary team and will result in a support plan being developed that outlines both your identified health needs and a plan as to how you intend to meet your health goals.

The support plan will be accompanied by a budget calculator that identifies the amount of funding the NHS has calculated is required to support you in achieving your health goals.

Once your support plan and budget calculator have been approved by NHS NWL, your case manager will create a digital referral to the PHB Support Service.

As soon as a referral is received, our Independent Living Advisors (ILAs) will check to ensure we have all the information we require to properly support the setup of your Personal Health Budget on Virtual Wallet.

Our ILAs will then contact you by email or telephone to arrange a time for an initial discussion. During this conversation, the ILAs will look to understand a little more about you and your individual circumstance.

Following your initial discussion with our ILAs, we will understand more about how we can best support you with the next steps on your PHB journey. 

As the PHB holder or authorised representative, you remain in control and are responsible for ensuring the support you arrange is inline with the PHB agreement you have with NHS NWL.

Our ILAs role is to offer advice, and support  you through the process of setting-up your own care arrangements.

The ILAs can help you understand the elements that must be in place to ensure your support is safe and meets the requirements of the PHB agreement you have with NHS NWL.

Once you have identified the individuals or organisations that you wish to work with, the ILAs will liaise with the Virtual Wallet support team to get your support arrangements set-up in Virtual Wallet.

Getting these individuals or organisations registered on Virtual wallet will mean you are able to review and pay for the support you receive using your Virtual Wallet account.

Once your account is active, NHS North West London will send the agreed amount of funding to your Virtual Wallet account.

Please be aware that it can take up to 6 weeks for the first payment to reach your Virtual Wallet account, from the date that your referral is received by the NHS NWL PHB support service.

Following the first payment, funding will be credited to your Virtual Wallet account on or around the 1^st of each month.

Once your support providers are set-up and funding is received, your Virtual Wallet account is live and ready to use.

The Virtual Wallet support team are on hand should you have any questions about how to access or use your Virtual Wallet account. 

The Virtual Wallet support team are available Monday to Friday from 8:30am - 5:00pm via webchat, email or telephone, and their contact details are available in the 'useful contacts' section of this webpage.

If you choose to receive support from a care agency, it is the care agencies responsibility to find a suitably qualified individual to provide support to you. The care agency will be the employer and they will: 

• Produce an invoice each period for the support that has been provided 
• Obtain insurance for their workers and complete all appropriate safeguarding checks 
• Be registered with an appropriate supervisory organisation, e.g. CQC  
• Manage salary and payroll 
• Be responsible for employment rights like holiday and sick pay 
• Sort out any issues, i.e. misconduct or performance issues 
• Send a replacement if the allocated individual is ill 
• Have a pool of individuals to provide 24-hour care 

Whilst receiving support from an agency can often be a more simple way to meet your care needs, there are some other considerations to take into account. These include: 

• Whilst the carer that the agency sends should always be suitably qualified, the agency may not always be able to send the same individual each day. If consistency and familiarity with the carer is important to you, it is vital that you discuss this with the agency and make them aware. 
• As the agency may not be able to send the same carer each day, there could be some variation in how the individual completes tasks and supports you. Whilst the support they deliver will be in line with your support plan, if you have particular concerns around how tasks are completed, it is important that you discuss this with the agency and make them aware.
• Whilst the agency will agree to deliver a set number of hours of support, they may not always be able to guarantee to come at a set time. If you have specific or set requirements, it is important you discuss this with the agency and make them aware. 

Arranging for a care agency to provide support to you is a straightforward process. However, it is important that you ask certain questions and obtain some assurances from the care agency to ensure the support they provide is safe, and in line with your expectations. 

Follow steps 1 to 4 below to read more about the process:

You may have already discussed with your case manager which care agency you would like to work with. If you require any help understanding which care agencies are available locally, please contact your Independent Living Advisor. 

Before you enter into any agreement, it is important that you speak to the care agency and understand:

• • Do they have capacity to take on new clients in your area?
  • How much do they charge per hour?
  • Are they able to meet any specific requirements you may have (i.e. gender of carer, specific timing of visits)
  • Is the agency CQC registered?
  • Can they provide confirmation of appropriate training and insurance?

It is also important that you confirm the rate charged by the agency is inline with the funding provided through your PHB agreement. Please speak to your Independent Living Advisor if you require any support with this.

Once you have selected the care agency you would like to work with, you will need to let your Independent Living Advisor know so they can start the process of registering the care agency on Virtual Wallet.

To do this, the Independent Living Advisor will need to know:

• • The name of the care agency 
  • A contact number and email address for the care agency 
  • The name of a main point of contact at the care agency 
  • The number of hours of support you have agreed 
  • The cost of the support per hour 
  • When they will start to provide support to you

If you could provide this information to your Independent Living Advisor via email, that would be ideal - but they are happy to take this information over the phone if that is easier for you.

Once they have all the appropriate information, your Independent Living Advisor will arrange for the Virtual Wallet support team to contact the care agency, inviting them to register on Virtual Wallet.

This is a simple process for the care agency and once completed, will allow them to submit invoices for payment through your Virtual Wallet account. A number of care agencies across North West London are already registered on Virtual Wallet, so it may be that we are working with them already.

The Virtual Wallet support team will liaise with the care agency directly to get everything set-up in advance of the start date on your PHB

Once the care agency is registered, you will receive an email confirming your Virtual Wallet login details and instructions on how to manage your Virtual Wallet account.

The care agency should start providing care inline with the arrangements you have agreed with them and will generate invoices using Virtual Wallet that you can review at any time using your Vitual Wallet account.

If you need any help or support accessing your Virtual Wallet account, please contact the Virtual Wallet support team - their contact details can be found in the 'contacts' section at the bottom of this page. 

If you choose to employ a personal assistant to provide support, you have the flexibility to recruit individuals that you feel can best help you to meet your care needs. 

As you are the employer, you are able to:

• Tailor the support your employees provide
• Choose the hours that they work
• Ensure continuity of support and build a working relationship with the individual 
• Recruit to meet your individual requirements i.e. PA gender, skills, personality

Whilst receiving support from a personal assistant provides the most control and flexibility, it does mean you take responsibility as an employer and need to consider additional factors including: 

• You will need to arrange cover for your personal assistant when they are unavailable due to sickness or holidays
• You take on the responsibility of being an employer
• You are responsible for the recruitment process, which can take time to complete successfully

There are a number of key steps to employing personal assistants - the below summary is designed to help ensure the arrangements you put in place are both safe and comply with all relevant employment legislation. 

It may be that you already know, or have identified the individual you wish to employ as a personal assistant. In this instance, you still need complete a number of the stages below, to ensure the support you receive is safe and aligned to your PHB agreement with NHS NWL.

If you require assistance with any stage of the process, please contact your Independent Living Advisor who will be happy to assist.

You may also find it useful to look at this toolkit for Individual Employers that has been produced by Skills for Care

To find out more about the process of employing a personal assistant, please follow steps 1 to 6 below:

The first step on the journey to employing your own personal assistants is to find the individual that you would like to provide support to you. It may be that you have already identified the individuals you wish to work with, but if this is not the case, you will need to work through the recruitment process.

Important tasks include:

• Produce a job description and person specification - this is where you can set out the tasks you will require your personal assistant to complete and can detail the skills and characteristics you are looking for.
• Writing a job advert - this is where you will set-out important details, such as rates of pay and hours of work
• Advertising the role - most individuals find that a combination of traditional and digital advertising works best. 
• Shortlisting candidates - this is where you work through the list of candidates and make decisions on who you would like to invite to an interview
• Conducting interviews - meeting the candidates and asking them question about their skills and experience will help you to decide who is the best fit for your role.

 If you require any support with this process, our Independent Living Advisors can offer a range of support, including providing you with template documents that you may wish to use.

Once you have found the individual that you wish to employ as a personal assistant, there are a number of important tasks to complete before you can issue a formal contract of employment:

• Conditional offer - this is where you formally write to the individual offering them the role as your personal assistant, subject to the successful completion of some pre-employment checks
• References - the individual should have provided details of someone that will act as a referee when they applied for the role. You will need to contact this individual and request a reference. 
• Enhanced DBS certificate - You will need to apply for an Enhanced DBS certificate for each PA. There is funding to cover this in your PHB and your Independent Living Advisor is able to support you with this process. Please ask your Independent Living Advisor for further information.
• Right to Work (RTW) check - Before you issue a contract of employment, you need to confirm the individuals right to work in the UK. This can be confirmed by the individual providing an official document from a list issued by the UK government. An up-to-date list of appropriate documents is available on the UK government website - Check if a document allows someone to work in the UK - GOV.UK (www.gov.uk)

Once you have successfully completed all the pre-employment tasks highlighted in Step 2,  you are ready to start preparing for your PAs first day at work. Important tasks to complete in advance of your PAs start date include:

• Contract of employment - You will need to issue a formal offer of employment to your personal assistant. This will detail important information including:
  • Probationary period
  • Rate of pay
  • Hours of work and breaks
  • Pension arrangements
  • Holiday entitlement
  • Notice period
  • Illness absence process and pay
• HMRC Registration - It is a legal requirement that you register as an employer with HMRC. Once registered, HMRC will provide you with an employer PAYE reference number that you will need to pass to your payroll provider. Registration with HMRC is a straightforward process that can be completed online - Register as an employer - GOV.UK (www.gov.uk). Please contact your Independent Living Advisor if you require any support working through the online form.   
• Payroll  - It is important to ensure that payments to both your PAs and statutory organisations such as HMRC are made accurately and on time. One of the simplest ways to achieve this is to employ the services of a payroll provider to manage this for you. There is a payroll solution called Vitual Wallet Payroll included as part of your Virtual Wallet account. Alternatively you can choose to work with another payroll 3rd party payroll organisation. Please speak to your Independent Living Advisor for further information.
• Home Employment Insurance - Ensuring appropriate insurance is in place is crucial. These policies are designed for individual employers and can offer protection in a variety of scenarios. Typically, these policies provide cover both inside and outside the home and can be extended to cover specific delegated healthcare tasks as required.  Policies are available from a range of specialist insurance providers, including Mark Bates Ltd and Fish Insurance
• Training - Your support plan will detail a range of training that is recommended your personal assistants complete to help ensure the support you receive is safe. Your insurance provider will often provide access to a range of courses as part of your Home Employment policy. Alternatively, your Independent Living Advisor can help you to source appropriate training providers in your area.
• Health and safety - It is your responsibility to ensure your personal assistants are safe whilst at work. If you employ more than 5 PAs, you will need a health and safety policy. If required, your Independent Living Advisor is able to provide you with a template document to complete. 

Once you have identified the individual who you wish to employ as a personal assistant, you will need to let your Independent Living Advisor know so they can start the process of registering the personal assistant on Virtual Wallet.

To do this, the Independent Living Advisor will need to know:

• • The name of the personal assistant 
  • A contact number and email address for the personal assistant 
  • The contracted number of hours of support they will provide each week
  • The gross rate of pay
  • The date which personal assistant will start to provide support to you

You will also need to confirm which payroll provider you wish to work with.

If you choose to use Virtual Wallet Payroll, your Independent Living Advisor will be able to help start the payroll registration process with the Virtual Wallet payroll team. 

If you choose to use a 3rd party payroll provider, you will need to contact the organisation directly and complete their own registration forms. Your Independent Living Advisor will need to know:

• • The name of the 3rd party payroll provider
  • A contact number and email address for the 3rd party payroll provider

If you could provide this information to your Independent Living Advisor via email, that would be ideal - but they are happy to take this information over the phone if that is easier for you.

Once they have all the appropriate information, your Independent Living Advisor will arrange for the Virtual Wallet support team to contact your personal assistant, inviting them to register on Virtual Wallet.

This is a simple process for the personal assistant and once completed, they will be will be sent their own Virtual Wallet log-in details., allowing them to submit timesheets for you to review using your own Virtual Wallet account.

The Virtual Wallet support team will liaise with the personal assistant directly to get everything set-up in advance of the start date on your PHB. 

If you have chosen to work with a 3rd party payroll provider, the Virtual Wallet support team will contact them to invite them to register on Virtual Wallet and agree a way of working together to ensure payroll runs smoothly for both you and your employees.

Once your personal assistant is registered on Virtual Wallet,  you will receive an email confirming your Virtual Wallet login details and instructions on how to manage your Virtual Wallet account.

The personal assistant should start providing care inline with the arrangements you have agreed with them and submit timesheets on a regular basis using Virtual Wallet. 

You should review and approve these timesheets within 3 days of them being submitted using your Vitual Wallet account.

If you need any help or support accessing your Virtual Wallet account, please contact the Virtual Wallet support team - their contact details can be found in the 'contacts' section at the bottom of this page.

Once your PHB has been agreed by NHS NWL, your case manager will complete a referral form that passes all the relevant information to the NWL PHB Support Service. 

When we receive the referral form from NHS NWL, one of our Independent Living Advisors will make contact with you, or your nominated representative to introduce themselves and confirm the basic information we have received. 

Our ILA will then work with you to understand how you wish to achieve your identified health goals and support you to get your PHB up and running as soon as possible. 

More information on the support our Independent Living Advisors are able to offer is available on this page.

Our Independent Living Advisors will attempt to make initial contact with you within 1 working day of your referral being received. 

When a new referral is received, our Independent Living Advisors will review the information that has been provided by the case manager to ensure we have everything we need to progress the referral - if there are any queries, there may be a slight delay whilst we work with your case manager to resolve these. 

Our Independent Living Advisors should be your first stop for any queries relating to your Personal Health Budget. 

If your query relates to something the Independent Living Advisors cannot answer directly, they are happy to liaise with case managers at NHS NWL on your behalf, or signpost you to other support organisations if appropriate. 

At the point your PHB referral is sent to the PHB Support Service, your case manager is also responsible for ensuring that NHS NWL start the process of making your funding available to you in Virtual Wallet.

It can take up to 6 weeks from the point your referral is received by the NWL Support Service for your first payment to be available in your Virtual Wallet account. 

After the first payment, funds will be deposited into your Virtual Wallet account on or before the 1st of each month.

You are able to use your PHB funding for anything that is detailed in your support plan. 

If you decide that you wish to use your PHB funding for something that is not detailed in your support plan, please speak with your Independent Living Advisor.

Whilst your Independent Living Advisor is unable to amend your support plan, they are happy to liaise with your case manager who will be able to review your request and submit a revised support plan for approval by NHS NWL. 

The first step would be to speak to your Independent living Advisor. 

They will be able to help you to understand if the changes you are looking to make are in line with your current support plan and if funding is available within the budget that has been agreed to support these changes.

If any changes to the support plan or funding amount is required, your Independent Living Advisor will liaise with your case manager at NHS NWL to understand the options that are available to you. 

This could result in a new support plan and budget being provided for you. 

Whilst using a self-employed personal assistant to meet your support needs does mean that some management activity like payroll is dealt with by the personal assistant themselves, there are still a number of checks and assurances that you need to have in-place:

• Confirmation of employment status - it is your responsibility as the individual managing the Personal Health Budget and arranging the services of the personal assistant to confirm the correct employment status of the individual for tax purposes. You can do this on the UK government website - Check employment status for tax - GOV.UK (www.gov.uk)
• Unique Taxpayer Reference (UTR) - NHS North West London are required to ensure that all individuals in receipt of PHB funding are meeting their obligations in respect to the payment of HMRC contributions where appropriate. When you choose to contract the services of a self-employed PA, you retain an element of responsibility to ensure that the self-employed PA is registered with HMRC. The agreed way to achieve this is by obtaining a copy of the individuals Unique Tax Reference (UTR) and address of their tax office on HMRC letterhead.
• Enhanced DBS certificates - it is your responsibility as the individual managing the Personal Health Budget and arranging the services of the personal assistant to confirm that each personal assistant has an Enhanced DBS Certificate. There is funding to cover this in your PHB and your Independent Living Advisor is able to support you with this process. Please ask your Independent Living Advisor for further information.
• Personal Assistant Insurance - it is your responsibility as the individual managing the Personal Health Budget and arranging the services of the personal assistant to confirm that each personal assistant has appropriate insurance in place. These policies are specifically designed for self employed personal assistants and offer a range of protection that can be extended to include delegated healthcare tasks where appropriate. There are a number of specialist insurance providers that offer these policies, including Mark Bates Ltd and Fish Insurance 

The NWL PHB Support Service is working to complete annual reviews of all PHB accounts. 

This is to help ensure that the PHB continues to meet your identified health needs and to help you prepare for the annual financial audit of your account.

The Independent Living Advisors are able to work with you check you have all the necessary safeguards in place to make ensure that the support you receive is safe and meets the requirements of your PHB agreement.