Continuing healthcare (CHC) is a complex process and this page offers a summary. A full guide can be found on the What is Continuing Healthcare? section of the NHS Choices website or in the public information leaflet ‘NHS Continuing Healthcare and NHS-funded Nursing Care’ published by the Department of Health
The National Framework for NHS continuing healthcare and NHS funded nursing care sets out the principles and processes of the National Framework, the framework documents can be viewed here.
If you need any support or advice at any stage of the process, there are a number of independent organisations who can support you. Click here for further information.
NHS Continuing Healthcare is the name given to a package of care arranged and funded solely by the NHS for patients (over 18 years of age) who are not in hospital but have a complex medical condition and substantial and on going care needs. The patients must have a 'primary health need', which means that their main need for care relates to their health.
It is possible for patients to move in and out of eligibility for CHC. So, where patients are eligible for CHC, it is put in place for up to three months in the first instance, and usually from then on, reviewed annually.
How is a patient assessed for CHC eligibility?
The process usually begins with an assessment by a health or social care professional, helped by the use of a screening method called a Checklist Tool. This might be done, for example, by a nurse or social worker before a patient leaves hospital, or by a district nurse or social worker while carrying out a community care assessment. (Occasionally, an application will be passed to the next stage - full assessment - without the checklist stage being done. There is also a Fast Track route, used when appropriate).
The assessment is done with the patient (and/or their representative where appropriate). Patients seen as possibly eligible for CHC have a named co-ordinator appointed by Bedfordshire CCG. The co-ordinator arranges for a full assessment. This will be carried out by a multidisciplinary team of health and social care professionals, using a Decision Support Tool. (The tools are used to help streamline the process and aid consistency of approach).
Further information on applying for CHC can be found here.
Claims and Redress
In April 2015 NHS England published the refreshed NHS Continuing Healthcare Redress Guidance.
The document reflects the ‘Principles for Remedy’ from the Parliamentary and Health Service Ombudsman for all public bodies. It maintains the principles of fairness to ensure that individuals are returned to the financial position that they should have been had they later been found eligible for continuing healthcare, whilst ensuring nobody makes financial gain from the public purse. CCGs will continue to consider the specific circumstances of each individual case when determining the appropriate level of redress.
You can find more information and the guidance from NHS England here.
CHC team's contact details:
Beds MK45 4HR
Tel: 01525 624300