NHS Continuing Healthcare (CHC) is a package of care arranged and funded solely by the NHS in England for a person who is aged 18 or over and has been found to have a ‘primary health need’ that has arisen because of disability, accident, or illness.
Continuing Healthcare can be used to pay for care and in any setting including: care at home, residential or nursing homes and the accommodation
The Clinical Commissioning Group (CCG) that holds the contract with the GP practice responsible for care at the time of application is responsible for deciding eligibility to Continuing Healthcare.
The National Screening Continuing Healthcare Checklist aims to help trained health/social care professionals identify people who should have a full assessment to determine their eligibility.
Following the checklist, if appropriate, a full assessment will be carried out by a Multi-Disciplinary Team (MDT) and the Decision Support Tool (DST) used to establish eligibility to CHC.
The checklist is based on 11 out of 12 care domains (areas of care need) used in the decision support tool. The domain ‘other significant needs’ is not used in a checklist
The primary health need should be assessed by looking at all the care needs and relating them to twelve care domains (below) AND four key indicators; nature, intensity, complexity, and unpredictability.
If someone has been screened out from full consideration following use of the Checklist, they may ask the CCG to reconsider its decision and agree to a full assessment of eligibility.
Where a full assessment has been undertaken of potential eligibility using the Decision Support Tool (or by use of the Fast Track Pathway Tool), and a decision has been reached, challenging that decision should be addressed through the local resolution procedure, initially.
The Fast Track pathway tool is used when a person has a rapidly deteriorating condition and may be entering a terminal phase. It can only be completed by an ‘appropriate clinician’ and contains sufficient evidence to establish eligibility. Where it is appropriate to use the Fast Track Pathway Tool, this replaces the need for a Checklist and DST to be completed
Funded Nursing Care Payment
NHS continuing healthcare must be considered, and a decision made prior to any consideration of eligibility for NHS-funded nursing care. Funded Nursing Care Payment is a weekly payment currently £155.05 per week (2017/18), this is reviewed annually and provided by the NHS to homes providing nursing care, to support the provision of nursing care by a registered nurse