What is NHS Continuing Healthcare?

What is NHS Continuing Healthcare?

In a nutshell, NHS Continuing Healthcare is NHS fully funded care that is provided for individuals who are not in hospital and have been assessed as having a primary health need.

A couple of the many misconceptions are: –

  1. I have to be in a nursing home/care home to receive it.  No, the care may be provided in your own home
  1. It is depended on my income and size of my bank account.  No, NHS Continuing Healthcare is not means tested.

Nevertheless, it is still difficult to meet the criteria for obtaining NHS Continuing Healthcare because its looks at a whole range of needs together with their severity and complexity.  When reviewing and assessing your needs, you may be reviewed using a screening tool called the Checklist to identify if you may be eligible for NHS Continuing Healthcare. However, it is not an indication as to whether or not you are actually eligible. This can be done by a nurse if you are in hospital and on a pathway to being discharged; a doctor or nurse in your own home or a social worker.  There are other practitioners that may also be able to complete the Checklist.

This Checklist looks at your healthcare needs by looking at various healthcare needs called domains.   (These domains are the same as what is looked at in the Decision Support Tool and are outlined below).  If after going through the Checklist it suggests you may be eligible, the local clinical commissioning group (CCG) will then write to you to confirm whether or not you will be referred for a full assessment of your needs.  This assessment is carried out by a multidisciplinary team, using a tool called the Decision Support Tool. (For individuals who need an urgent package of care because their condition is deteriorating rapidly, the Fast Track Tool may be used instead.   This enables the CCG to arrange for care to be provided as quickly as possible).  This tool is used to assess whether your main or primary care needs relate to your health, by looking at the following types of care need:

  • behaviour
  • cognition (understanding)
  • communication
  • psychological / emotional needs
  • mobility (ability to move around)
  • nutrition (food and drink)
  • continence
  • skin (including wounds and ulcers)
  • breathing
  • symptom control through drug therapies and medication
  • altered states of consciousness
  • other significant needs

These needs are then given a weighting marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”.  The multi-disciplinary team will consider:

  • what help is needed
  • how complex these needs are
  • how intense or severe these needs can be
  • how unpredictable they are, including any risks to the person’s health if the right care isn’t provided at the right time.

Upon a full assessment and taking into account information that has been provided, the multidisciplinary team will then make a recommendation to the CCG about your eligibility.  The CCG will then write to you to confirm whether or not you are eligible.  If you are eligible for NHS Continuing Healthcare, the next stage is to arrange a suitable care package.  Please be aware that your eligibility for NHS Continuing Healthcare will be reviewed regularly.  If your care needs change, the funding arrangements may change.  This review normally takes place after three months and thereafter at least annually.

The NHS Continuing Healthcare Checklist and the Decision Support Tool can both be downloaded at:

https://www.gov.uk/government/publications/national-framework-for-nhs-continuinghealthcare-and-nhs-funded-nursing-care    It is also worth taking a look at http://www.nhs.uk/chq/Pages/2392.aspx?CategoryID=68   This also has links to the Checklist and Decision Support Tool.