NHS Continuing Healthcare
NHS Continuing Healthcare (NHS CHC) is a package of care for adults aged 18 or over which is arranged and funded solely by the NHS. NHS CHC is for individuals who are not in hospital and have been assessed as having a ‘primary health need’. NHS CHC is free, unlike social and community care services provided by local authorities for which you may be charged. NHS CHC is continually monitored and audited to ensure compliance with NHS Frameworks, guidance and policies as well as local policies, such as the Choice and Resource Allocation Policy which ensures fairness, transparency and quality across decision making and care packages.
Who is eligible for NHS Continuing Healthcare (CHC)?
You must be an adult aged 18 or over and have substantial and ongoing care needs. You must also have been assessed as having a ‘primary health need’, which means that your main need for care must relate to your health.
Eligibility for NHS CHC does not depend on:
- A specific health condition, illness or diagnosis
- Who provides the care, or
- Where the care is provided
You may not be eligible for NHS CHC even if you have a disability or have been diagnosed with a long-term illness or condition.
A decision about eligibility should usually be made within 28 days following the decision that a full NHS CHC assessment is required.
How is eligibility for NHS Continuing Healthcare (CHC) assessed?
Your local Clinical Commissioning Group (CCG) will assess your eligibility for NHS CHC. In most cases, an initial checklist is used to decide whether you need a full assessment. However, if you need care urgently because your condition is deteriorating rapidly and you may be reaching the end of your life your assessment may be fast-tracked.
The initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker. You should be told that you are being assessed, and asked for your consent. This initial assessment is carried out using the NHS Continuing Healthcare checklist.
If this shows that you should be considered for a full assessment of eligibility for NHS CHC, the person who completed the initial assessment will contact your local CCG to arrange a full assessment of all your care needs.
Full assessments are undertaken by a ‘multi-disciplinary team’ made up of a minimum of two health or care professionals who are already involved in your care, to build an overall picture of your needs. You may invite a carer, relative, friend or other advocate to provide support and information during the assessment.
The decision regarding eligibility is reached using the evidence from the full assessment of your needs within a more complex set of indicators, known as the NHS Continuing Health Care Decision Support Toolkit. You will be given a copy of the decision documents, along with clear reasons for the decision.
For more information, read How will my eligibility for NHS Continuing Healthcare be assessed?
Fast-track assessment for NHS Continuing Healthcare (CHC)
If your condition is deteriorating quickly and you may be nearing the end of your life, you will be considered for the CHC fast-track pathway, so that an appropriate care and support package can be put in place as soon as possible – usually within 48 hours.
Where is NHS Continuing Healthcare (CHC) provided?
If you are eligible, you can receive NHS CHC:
- In your own home – the NHS will pay for healthcare, such as the services of a community nurse or specialist therapist, and personal care such as help with bathing, dressing and laundry, or
- In a care home - as well as paying for healthcare and personal care, the NHS will pay for your care home fees, including board and accommodation.
What if my care needs change?
Your eligibility for CHC will be reviewed regularly and, if your care needs change, the funding arrangements may also change. For more information, read When will my needs for continuing care be reviewed?
What if I am not eligible for NHS Continuing Healthcare (CHC)?
If you are not eligible for NHS CHC you can be referred to your local authority to discuss whether they can support you. If you still have some health needs then the NHS may still pay for part of the package of support. This is sometimes known as a ‘joint package’ of care.
You may be assessed as requiring nursing care in a care home registered to provide nursing care, in which event the NHS will pay a contribution towards the cost of your registered nursing care. This is known as NHS-funded Nursing Care and is available irrespective of who is paying the rest of the care home fees.
NHS England has issued guidance on how people can be compensated following eligibility disputes and delays in receiving NHS continuing healthcare which can be accessed here.
For general information:
For more information visit NHS England’s Continuing Healthcare website:
https://www.england.nhs.uk/ourwork/pe/healthcare/ or email: firstname.lastname@example.org
You may also find the following website of interest:
NHS Choices - What is NHS Continuing Healthcare?
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