What Is NHS Continuing Healthcare?
NHS Continuing Healthcare is a free package of care for people who have significant ongoing healthcare needs. It is arranged and funded by the NHS. You can receive NHS Continuing Healthcare in any setting outside hospital, including in your own home or in a care home. If you receive care in your own home, the NHS will cover the cost of the support you need from health professionals and the cost of personal care which can include help with washing and getting dressed.
Who Is Eligible?
Eligibility for NHS Continuing Healthcare isn’t based on whether you have a specific health condition.
To get NHS Continuing Healthcare you must:
If you have ongoing health needs, there are particular times when NHS staff or a member of the social work team should consider whether you may be eligible for NHS Continuing Healthcare:
In these circumstances, your discharge staff, staff co-ordinating your intermediate care, GP or a member of the social work team should raise the issue of NHS Continuing Healthcare and assess your eligibility. If they don’t, make sure you ask for an assessment.
Speak to your doctor or social worker if you think you might be eligible for NHS continuing healthcare. They can make a referral to the relevant CCG. You can also approach your CCG and explain why you believe you should be considered for NHS continuing healthcare. Your CCG is the one your GP practice is aligned to.
How does the Assessment Process Work?
The assessment process usually starts with the completion of the Checklist tool by a nurse or a social worker trained to complete it. This identifies whether you need to have a full NHS Continuing Healthcare assessment.
In some situations, it will be clear to health and social care staff that your needs do not indicate NHS Continuing Healthcare at this time. If health and care staff agree, they should record this in your notes, with their reasons. If there is any doubt between staff, they should complete the Checklist.
If your condition is deteriorating rapidly and you may be approaching the end of life, staff may decide to submit a proposal for you to be Fast Tracked for NHS Continuing Healthcare, which follows a quicker process.
If you’re referred for a full assessment, evidence will be collected from all relevant health and social care professionals about your physical, mental health and social care needs.
A team of health and social care professionals will meet to look at this evidence, complete a Decision Support Tool, and make their recommendation as to whether or not you’re eligible. You and / or your representative can attend and participate at this meeting.
Their recommendation is given to the Clinical Commissioning Group (CCG) responsible for agreeing and funding your care package. Except in exceptional circumstances, the CCG confirms their recommendation.
The CCG should write to you with their decision and explain the reasons for it.
Personal Health Budgets
If you’re found to be eligible for NHS Continuing Healthcare the CCG will discuss with you what care and support you need and you have the right to ask for a Personal Health Budget. This can give you more choice over the services and care you receive and the provider you wish to use.