NHS Continuing Healthcare
NHS Continuing Healthcare refers to a package of ongoing care that is arranged and funded solely by the NHS where the individual has been assessed and found to have a ‘primary health need’ as set out in the National Framework.
NHS Continuing Healthcare (CHC) is the name given to a package of care that is arranged and funded by the NHS for people outside of hospital who have ongoing healthcare needs.
NHS Continuing Healthcare can be provided in a variety of settings, such as in your own home or a care home.
Who is eligible for NHS Continuing Healthcare?
NHS Continuing Healthcare is provided to an individual aged 18 or over to meet needs that have arisen because of a disability, accident, or illness and who have been found to have a ‘primary health need’.
You will be assessed by a team of health and social care professionals against a set criteria. This will include:
• what help you need
• how complex your needs are?
• how intense your needs can be?
• how unpredictable they are, including the risks to your health if the right care was not provided at the right time
Your eligibility will depend on your assessed needs and not on any diagnosis or condition you have.
How do assessments work?
NHS Continuing Healthcare can appear to be a complex and sensitive process which affects people at a very uncertain stage of their lives. The Continuing Healthcare Team (local CHC team) will involve you, your family, and carers in your assessment. For anyone who is not able to decide about their care on their own, their representative can be involved to act on their behalf.
For most individuals there is an initial checklist assessment. This is the screening tool used by health and social care staff to identify people who may be require a full assessment for NHS Continuing Healthcare. The checklist does not indicate whether the individual is eligible for NHS Continuing Healthcare, only whether they require full assessment of eligibility for NHS Continuing Healthcare.
If the checklist has been completed and indicates that there is a need to conduct a full assessment of eligibility for NHS Continuing Healthcare the CHC team will arrange for a multidisciplinary team to carry out an assessment of your needs.
Your eligibility for NHS Continuing Healthcare depends on your assessed needs, and not on any diagnosis or condition. A decision about eligibility for NHS Continuing Healthcare should usually be made within 28 days of an initial assessment or request for a full assessment.
The multidisciplinary team will also consider your views and together with all this information a recommendation is put forward to your local NHS commissioners for a decision about funding.
If your needs change then your eligibility for NHS Continuing Healthcare may also change.
What is a Fast Track Tool?
There are times where a person needs an urgent package of care due to a rapidly deteriorating condition which may be entering a terminal phase; in these situations, an appropriate clinician will complete the Fast Track Tool. Your local CHC team will then process this and arrange a package of care as quickly as possible.
What happens if I am not eligible for NHS Continuing Healthcare?
You may be referred to social services who can discuss with you whether you may be eligible for support from them.
If you still have some health needs, then you may be referred to universal/ specialist NHS services. In some circumstances you may be eligible for a ‘joint package of care.’ This is where the NHS and social services both contribute to some part of your package of care.
If you live in a care home offering nursing care, you may be eligible for NHS Funded Nursing Care. This may follow a CHC assessment where you have been found not eligible for CHC. This type of funding is available for people who have registered nursing needs and are receiving care in a care home with nursing provision. Please be aware that being a resident in a care home with nursing provision does not automatically indicate eligibility for Funded Nursing Care.
A review of your care needs will be undertaken at regular intervals. If following a review, changes are identified which mean you no longer meet the eligibility criteria for NHS Continuing Healthcare, social services may be asked to conduct an assessment to determine if you are eligible for support from them. You will be able to continue to receive care from universal / specialist NHS services if appropriate.
What is Children and Young People's Continuing Care?
Some children and young people may have very complex health needs requiring additional health support which is not routinely available. This additional health support is called continuing care. The children’s continuing care team in your local area is responsible for assessing children and young people to see if they are eligible for continuing care. This is guided by the National Framework for Children and Young People’s Continuing care (Department of Health 2016).
Children and young people’s continuing care national framework - GOV.UK (www.gov.uk)
A continuing care package may be required when a child or young person has needs arising from a disability, accident or illness that can not be met by existing universal or specialist services alone.
If a child is eligible for NHS Continuing Care, it is likely that a range of organisations will be involved, such as health, education, and local authority children’s services. These different agencies may contribute to a child’s package of care if they are found to have continuing care needs. A package of care is discussed with the child or young person (where appropriate) and their family and the best way of managing it is agreed. This may include offering a child or young person a Personal Health Budget.
What is a Personal Health Budget?
A Personal Health Budget is an amount of money to support someone’s health and wellbeing needs, which is planned and agreed between the you and your representative. It is not new money, but a way of spending money differently so you can get the care you need. A Personal Health Budget allows you to manage your healthcare and support such treatments, equipment, and personal care, in a way that suits you. There are some restrictions on how the budget can be spent.
The right to have a Personal Health Budget applies to adults receiving NHS Continuing Healthcare (NHS funded long- term health and personal care provided outside hospital) and children in receipt of continuing care.
People who become eligible for continuing healthcare under the Fast Track process also have a legal right to have a Personal Health Budget.
For further information on Personal Health Budgets in NHS Continuing Healthcare click here: Personal health budgets in Continuing Healthcare
NHS guidance on Continuing Healthcare redress
NHS England has published guidance if individuals want to claim for retrospective funding of Continuing Healthcare needs.
How do I contact my local NHS Continuing Healthcare Team?
- Cheshire East - email@example.com - Bevan House, Barony Ct, Nantwich CW5 5RD
- Cheshire West - firstname.lastname@example.org - 1829 Building, Liverpool Rd, Chester, CH2 1HJ
- Halton and Warrington - WARCCG.CHC@nhs.net - No.1 Lakeside, 920 Centre Park, Warrington, WA1 1QY
- Knowsley - Knccg.email@example.com / 0151 244 4126 - Nutgrove Villa, Westmorland Road, Huyton, L36 6GA
- Liverpool and Sefton - For individuals in Residential Homes, Own Home and Supported Living 0151 295 3901. For individuals in Nursing Homes 0151 433 6988- The Department, 2 Renshaw Street, Liverpool, L1 2SA
- St Helens - CHCTeam@sthelens.gov.uk / 01744 675260 - Forster House, Waterside, St Helens, WA9 1UB
- Wirral - firstname.lastname@example.org - Marriss House, Hamilton Street, Birkenhead, Wirral, CH41 5AL