NHS Continuing Healthcare

Continuing Healthcare (CHC) is free care that is arranged and funded by the NHS, for adults with long-term complex health needs. NHS Continuing Healthcare is available in England, Northern Ireland and Wales.

Older patients discharging from hospital should be assessed for NHS Continuing Healthcare before being discharged from hospital.

NHS Continuing Healthcare can be provided in your own home, where the NHS will pay for nursing and personal care, or in a care home, whereby the NHS will pay the care home fees.

How To Prepare for your NHS Continuing Healthcare Assessment

1. Gather the most up-to-date evidence

You may want to discuss the assessment in advance with your care home or care agency. This will enable them to ensure that all relevant records such as care plans,risk assessments and daily records are up to date.

2. Ask for a care plan review

You may want to consider asking your care home manager or care agency to review your care plan. You can then use this to check the details of each element of your care that will be considered in the assessment paperwork, i.e The Decision Support Tool.

3. Detail any complex issues

If there is an area of care that is particularly complex, for example, challenging behaviour or falls, it may be useful to ask the care home manager or care agency to ensure that recent records pertaining to this are available. It may even be appropriate to ask them to keep a detailed one-week log of all events related to that particular care need in the lead up to the assessment.

4. Make a diary

If you are a representative of the person who is to be assessed, it can help during the assessment if you are able to present a written record of your visits to the person in a diary format. Therefore, each time you visit the person, make a record of your visit. Consider how the person appeared to be, for example, did they greet you? Were they asleep? Did you assist them to eat and drink? Did they show any signs of challenging behaviour?

5. Keep the relevant paperwork for your CHC assessment

Do store in a safe place all the documentation sent to you by the Integrated care systems (ICSs) relating to both your Continuing Healthcare screening Checklist and your Full Assessment.

ICSs are partnerships of organisations that plan and pay for health and care services to improve the lives of local people.

Each integrated care system has two statutory elements, an integrated care partnership (ICP) and integrated care board (ICB).

Decision support tools (DSTs) will be sent to the ICB for their decision as to whether CHC should be awarded or not.

6. Jot down questions

Make a list of any questions you want to ask your coordinating assessor about the Continuing Healthcare assessment process. Potential questions could be around timescales for completion, completion of the decision support tool, care planning or how to appeal if you are not awarded Continuing healthcare.

Assessment for NHS Continuing Healthcare

An initial assessment will be completed by a nurse, doctor, other healthcare professional or social worker.

Depending on the outcome of the assessment, you’ll either be told that you don’t meet the criteria for a full assessment of NHS continuing healthcare and are therefore not eligible, or you’ll be referred for a full assessment of eligibility.

To see whether you qualify for NHS Continuing Healthcare, a healthcare team will assess the:

• complexity of your needs
• intensity or severity of your needs
• extent to which your needs may be unpredictable, and any potential effects on your health

The team’s assessment will consider your needs under the following headings:

• breathing
• nutrition (food and drink)
• continence
• skin (including wounds and ulcers)
• mobility
• communication
• psychological and emotional needs
• cognition (understanding)
• behaviour
• drug therapies and medication
• altered states of consciousness
• other significant care needs

NHS Continuing Healthcare reviews

If you are eligible for and begin an NHS Healthcare package, this should be reviewed within the first three months and at least every year after this.

This is to check whether the package of care agreed still meets your needs, or if changes are needed.

Summary

Who qualifies for NHS Continuing Healthcare?

To be eligible for NHS continuing healthcare, you must be an adult and be assessed by a team of healthcare professionals as having long-term complex health needs.

Does NHS Continuing Healthcare cover care given in a care home and within your own home?

NHS continuing healthcare can be provided in a variety of settings, such as in your own home or in a care home.

Can I pay top-up fees for NHS Continuing Healthcare?

No, unlike with Local Authority funding, you can’t pay top-up fees for NHS Continuing Healthcare packages.

How do I arrange NHS Continuing Healthcare?

In the first instance, approach your doctor or social worker (or medical team, if you are in hospital) if you think you might be eligible for NHS Continuing Healthcare.

What can I do if I’m not eligible for NHS Continuing Healthcare?

If your assessment doesn’t qualify you for NHS Continuing Healthcare but does assess you as needing a registered nurse, you may be eligible for NHS-funded Nursing Care. This is when the NHS pays for the nursing care component of nursing home fees.

Depending on your financial circumstances and where you live within the UK, you may also qualify for local authority funding towards the cost of care.