NHS Continuing Healthcare
NHS continuing healthcare is a package of care for a person who is in need of ‘ continuing care’ support from health professionals as a result of disability, accident or illness. If someone is eligible, then the NHS pays all the costs incurred for their care, this is subject to review, and should your care needs change the funding arrangements may also change. If the care required is of a more residential nature, then the patient or their relatives may have a contribution paid towards the cost.
Over the last few years, attempts have been made to make clear in law the type of healthcare needs that qualify for NHS continuing healthcare. A national framework has been developed to provide guidance to the NHS about this and to try to ensure that consistent decisions are made across the country.
NHS continuing healthcare assessments
How are decisions made about who is eligible for NHS continuing healthcare?
The whole of the decision making process should be ‘person centred’. This means putting the individual and their views about their needs and the care and support required at the centre of the process. It also means making sure that the individual plays a full role in the assessment and decision making process and gets support to do this where needed. This could be by the individual asking a friend or relative to help them explain their views. Primary care trusts (who manage local health services) should also make the individual aware of advocacy support services that may be able to assist.
There is guidance about the way assessments should be carried out. A checklist is commonly used to decide whether someone needs a full assessment. Some people who need an urgent decision, such as those who are terminally ill, should be fast-tracked to receive NHS continuing healthcare immediately.
Where is NHS continuing healthcare offered?
NHS continuing healthcare can be provided by the NHS in any setting, including a care home, hospice, hospital or the home of the person you look after. If NHS continuing healthcare is provided in a care home, it will cover the care home fees, including the cost of
What services will be provided?
If you are entitled to NHS continuing healthcare, the Primary Care Trust will discuss with you as to how your needs and care will be managed and the best setting in which to do that (eg. at home or in a care home) and which organisation will be responsible for providing for some or all of these needs.
You will have a review of your needs after three months and then at least every year. Neither the NHS nor a local authority should withdraw from an existing care arrangement without a joint review and reassessment of your needs, and without first consulting with one another and with you about the proposed changes
What is NHS-funded nursing care?
Most individuals will not need to have a separate assessment for NHS funded nursing care if they have already been considered for NHS continuing healthcare. However, if an assessment is needed your Primary Care Trust will arrange this.
By law, local authorities cannot provide registered nursing care. For individuals in care homes with nursing, registered nurses are usually employed by the care home itself and in order to fund this nursing care, the NHS makes a payment directly to the care home.
If after reading the above together with the public information booklet you feel that yourself or someone that you care for needs an assessment you can contact the NHS Continuing Care department on 01707 369574, fax: 01707 369572 or by writing to The Continuing Care Department, Charter House, Parkway, Welwyn Garden City, Herts. AL8 6JL
Deadline for assessment of eligibility for NHS Continuing Healthcare funding for cases during the period 1 April 2011 to 31 March 2012
On 15 March 2012, the Department of Health announced the introduction of deadlines for individuals to request an assessment of eligibility for NHS Continuing Healthcare (NHS CHC) funding, for previously un-assessed cases during the period 1 April 2004 – 31 March 2012.
NHS CHC is care provided over an extended period of time to meet physical or mental health needs that have arisen as a result of disability, accident or illness. NHS CHC funding is only provided where an individual has a primary health need and requires long term healthcare, as opposed to social or residential care.
We are therefore asking for individuals or their representatives to notify NHS Hertfordshire previously un-assessed periods of time where there is evidence that they should have been assessed for eligibility for NHS CHC funding. The time period and the deadline for notifying NHS Hertfordshire are as follows:
The deadline for the time period from 1 April 2004 – 31 March 2011 was 30 September 2012 and is now closed.
Some cases may be accepted after the date outlined above if there are exceptional circumstances for doing so.
The announcement of these deadlines introduced a process which will enable any individuals who should have been assessed from 1 April 2004 onwards to be identified and considered for eligibility as soon as possible, because as time passes, detailed recorded evidence of an individual’s needs for the period of time in question may no longer be available.