Disabled Travellers Seek Fairer UK Care Rules

Published: 18 September 2026. The English Chronicle Desk. The English Chronicle Online.

Disabled people who depend on personal assistants for round-the-clock support are facing renewed calls for clearer national rules governing the use of NHS-funded care when travelling overseas. MPs, peers and disability rights campaigners say people who require substantial assistance should not face different opportunities to travel simply because they live in different parts of the country.

The issue has come into focus after cases emerged in which people with similar disabilities and comparable care arrangements have received very different decisions from local NHS organisations about whether funding can contribute towards the costs of taking personal assistants abroad. Campaigners argue that the differences can have a major effect on whether an overseas trip is realistically possible.

Personal health budgets are designed to give eligible people greater choice and flexibility over how their assessed health and wellbeing needs are met. NHS guidance says people should be involved in developing their care and support plans and should have flexibility over how agreed funds are used to achieve their health and wellbeing outcomes.

However, the practical application of those principles can depend on local decisions. The cases highlighted in the latest debate have raised questions about whether a system intended to increase independence can inadvertently create additional restrictions for people who require personal assistants to travel.

One case involves Joel, a 40-year-old man with spinal muscular atrophy who works in marketing for a global brand. Joel is not his real name. According to the account of his case, he has been unable to take an overseas holiday with his personal assistants for several years because his local NHS funding arrangement does not contribute towards their travel expenses.

Joel can pay for his own travel, but travelling without his two personal assistants is not a realistic option because of the level of support he requires. As a result, a decision concerning the funding of his assistants’ expenses has had a wider impact on his ability to travel.

The situation was particularly frustrating because Joel had previously been permitted to use his personal health budget to help cover travel costs for his assistants. He took two short trips to Europe under the earlier arrangement, paying his own expenses.

Eight years ago, however, the funding decision was reversed. His NHS funder, now part of Cheshire and Merseyside NHS, subsequently took the position that relevant travel expenses were limited to journeys within the UK.

Joel challenged the decision. Earlier this year, he was reportedly told that the period in 2017 when overseas personal assistant travel expenses had been permitted represented a historical error in decision-making.

His experience has become part of a wider argument over whether people who have been assessed as requiring personal assistance should be able to use their support arrangements when travelling abroad.

Joel has argued that disabled people should have the same opportunities to travel, work and spend time with family as other members of society. Disability rights campaigners have similarly questioned why a person’s ability to take an overseas trip should depend on the policy of a local healthcare organisation.

A second case illustrates the geographical differences at the centre of the debate.

David, 25, whose name has also been changed, lives around 40 miles from Joel but falls under a different NHS organisation. He has the same health condition and a comparable care package. For several years, his requests for funding towards his personal assistants’ holiday expenses were rejected.

After presenting detailed evidence concerning NHS guidance and human rights law, however, his local NHS organisation changed its position last year. David was subsequently allocated £2,370 a year to contribute towards travel and accommodation costs for his personal assistants.

He was then able to take his first overseas trip without his parents. The trip was paid for by David himself, while the additional allocation helped make it possible for his support team to accompany him.

For David, the importance of travelling goes beyond the holiday itself. He has described the restrictions as affecting his sense of independence and his ability to experience life in a similar way to other young people.

The contrasting outcomes have prompted calls for a consistent national framework. Former disabled people’s minister Marsha de Cordova has argued that decisions about overseas travel should not depend on the approach taken by individual local officials.

Debbie Abrahams, chair of the House of Commons Work and Pensions Select Committee, has also raised concerns about whether restrictions could conflict with obligations under the United Nations Convention on the Rights of Persons with Disabilities, which the UK has ratified.

The debate centres on an important distinction within the personal health budget system. A personal health budget does not mean that every type of expenditure is automatically approved. Funding is connected to an individual’s assessed needs and agreed care plan, and NHS organisations retain responsibilities for ensuring that public money is used appropriately.

At the same time, NHS guidance places significant emphasis on choice and flexibility. People with personal health budgets are expected to participate in decisions about their care and to have agreed funds available to meet identified health and wellbeing needs.

NHS guidance also makes clear that personal health budgets operate within a framework of local decision-making. Certain people have a legal right to a personal health budget, while integrated care boards can offer budgets more widely to people they consider likely to benefit. Local organisations are responsible for determining aspects of their local offer beyond the statutory entitlement.

This structure has become a central part of the controversy. Campaigners argue that local flexibility should not result in substantially different opportunities for people with similar support requirements.

The Cheshire and Merseyside policy cited in the case states that disabled people can request holiday travel expenses for personal assistants but that such costs would not ordinarily be funded. The policy also refers to the responsibility of the NHS organisation to use its funds fairly and equitably.

NHS Greater Manchester, meanwhile, has reportedly said it did not have a ratified policy specifically covering holiday travel at the time of the case described.

The Department of Health and Social Care has maintained that integrated care boards should consider requests for personal assistant travel support individually. Its position is that decision-makers should take account of the health and wellbeing benefits of overseas travel alongside the relevant national policy and legislation.

The department has also emphasised the broader purpose of personal health budgets, saying they work best when people have meaningful flexibility in determining how their agreed budgets are used.

NHS organisations involved in the cases have said they cannot comment on individual patients but that personal health budget applications are assessed individually according to patient need and relevant policy. They have also said their policies are developed in line with national NHS guidance.

The dispute therefore reflects a wider challenge facing personalised healthcare. The system seeks to give people greater control while requiring local healthcare organisations to manage finite public resources and ensure that spending is linked to assessed needs.

For disabled people who depend on personal assistants, the difference between being allowed to use support funding abroad and being required to finance all additional costs themselves can be substantial. A holiday that appears affordable to someone travelling independently can become significantly more expensive when one or more support workers must also travel, stay and receive appropriate assistance.

The same issue can arise in other circumstances, including work-related travel, visiting relatives overseas or attending important personal events.

Existing government information on travelling abroad recognises the need for disabled travellers to plan accessibility, healthcare, transport and assistance carefully. It also advises travellers with existing health conditions to ensure that appropriate travel insurance arrangements are in place.

The current debate is not simply about holidays. Supporters of national guidance argue that the ability to travel can be connected to independence, employment, family relationships, social participation and quality of life.

At the same time, any national approach would have to address questions about eligibility, the circumstances in which public funding could contribute to personal assistant costs, how those expenses would be assessed and how NHS organisations could maintain financial accountability.

The issue is also emerging at a time when the structure of NHS commissioning is changing. Government proposals published in September 2026 include reforms affecting integrated care boards and their role as strategic commissioners.

For campaigners, the immediate priority is greater consistency. They argue that someone who has been assessed as requiring extensive personal assistance should not effectively lose the practical ability to travel because of their postcode.

For NHS organisations, the challenge is to balance individual needs and personal choice with their responsibility to distribute limited public resources fairly.

As the debate continues, the cases of Joel and David have provided a human dimension to an issue that can otherwise appear to be a technical question about healthcare budgets. Their experiences illustrate how decisions over relatively specific expenses can determine whether a disabled person is able to travel independently, spend time abroad with family or friends, or pursue opportunities outside the UK.

The calls for national guidance therefore centre on finding a clearer balance between local decision-making, financial responsibility and the principle of personal choice. For disabled people who require personal assistants, the outcome could determine whether overseas travel is treated as an ordinary part of independent life or as an exceptional activity subject to significantly different rules from one area to another.