What is NHS continuing healthcare?
NHS continuing healthcare is the name given to a package of care that is arranged and funded solely by the NHS for individuals outside of hospital who have ongoing healthcare needs.
Who is eligible for NHS continuing healthcare?
Anyone assessed as having a certain level of care needs may receive NHS continuing healthcare. It is not dependent on a particular disease, diagnosis or condition, or on who provides the care or where that care is provided.
Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS continuing healthcare may change.
To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a ‘multi-disciplinary team’) such as a nurse and a social worker from the Council as having a ‘primary health need’.
The views of other professionals such as occupational therapists, physiotherapists and doctors who have been involved in your care will also be taken into account to ensure that the assessment gives a full picture of your situation.
The assessment looks at all your care needs and relates them to four factors:
- nature – this is how your particular needs affect you, including the type of help you need
- complexity – this is about how your health needs affect each other and the level of skill required to manage them
- intensity – this is the extent and severity of your needs and the support needed to meet them
- unpredictability – this is about how hard it is to predict changes in your needs that might create challenges in managing them
Eligibility criteria for continuing healthcare are defined by NHS England.
The assessment will vary depending on the type of care you have been referred for. It will take place at a time and location agreed with you, and you can have family and/or other representatives with you if you wish.
After your assessment
You will be notified in writing of the outcome of your assessment. If you are not eligible, the reasons will be explained in the letter.
You will also be given details of how to appeal if you feel the decision is wrong. The professional who referred you will also be informed of the outcome of your assessment.
Care and support planning
If you are eligible for NHS continuing healthcare, the next stage is to arrange a care and support package which meets your assessed needs.
Depending on your situation, different options could be suitable. The continuing healthcare team should work collaboratively with you and consider your views when agreeing your care and support package and the where it will be provided, other factors such as cost and value for money of different options will be taken into account.
Reviews will take place to see if your needs are the same or have changed, and to check that the placement is meeting your needs. The placements officer will tell you when a review is due.
It is important that you understand the process and the reasons for any decisions made. If you do not, please contact the placements team, who can help explain these more clearly to you.
Personal health budgets
Adults who are eligible for NHS Continuing Healthcare (CHC) funding, and children in receipt of continuing care have had a legal right to have a personal health budget since October 2014. By April 2019, NHS England expects that unless there are exceptional circumstances, everyone living in their own home who is in receipt of standard CHC funding will have a personal health budget.
To find out more about NHS continuing healthcare call 020 8734 3021 or visit the NHS Choices website.