What is NHS Continuing Healthcare?
NHS Continuing Healthcare is the name given to care and support which is arranged and paid for by the NHS. It's also known as CHC funding and it's for people who have a primary health need that may have arisen as a result of a disability, accident, or illness. It may include funding for social care costs which would normally be paid for by an individual or the council. You can receive NHS Continuing Healthcare if you are living in your own home or in a care home.
NHS Continuing Healthcare is not means tested, unlike support provided by a local authority, for which a financial charge may be made depending on your income and/or savings.
If you are eligible for NHS Continuing Healthcare and you live in your own home, you will be offered your funding via a Personal Health Budget. This means that the NHS will pay for the care and support that you are assessed as needing and will arrange for a case manager to oversee your care. A Personal Health Budget is similar to a Direct Payment where you are given an allowance to pay for the service you need. It offers more choice and control on how care is arranged to best meet your assessed needs. It can help pay for care needs such as help with bathing and dressing, food preparation and shopping if these are part of your care plan.
If you live in a care home, NHS Continuing Healthcare can pay for your care home fees, including board and accommodation.
In Dorset, NHS Continuing Healthcare is provided via the Dorset Clinical Commissioning Group.
NHS Continuing Healthcare is available to people over 18 years old who have been assessed as having a primary health need that may have arisen as the result of a disability, accident, or illness.
Someone is eligible for NHS Continuing Healthcare if the main aspects or majority part of the care they require is focused on addressing and/or preventing health needs. It is not about the reason why an individual requires care or support, nor is it based on their diagnosis; it is about the level and type of their overall actual day-to-day care that needs to be taken in their totality. If you're eligible for NHS Continuing Healthcare, your care will be funded by the NHS. The care provided will be reviewed regularly and if your care needs change, the funding arrangements may also change.
The easiest way to know if you are eligible for NHS Continuing Healthcare is to ask your GP, community nurse, other health professionals, or social care worker to refer you for an assessment.
If you are not eligible for NHS Continuing Healthcare
If you live in your own home and are not eligible for CHC, the council may be responsible for assessing your care needs under the Care Act 2014. However, NHS healthcare services can still be accessed via your GP or community nursing services regardless of this.
If you are not eligible for NHS Continuing Healthcare and live in a care home with nursing you may be eligible for NHS funded nursing care.
NHS funded Nursing Care is the funding provided by the NHS to care homes providing nursing, to support the provision of care from a registered nurse care for those who are eligible.
NHS funded Nursing Care is paid directly to the care home where the person is living and receiving nursing care. It covers the cost of the registered nurse.
You may be eligible for NHS-funded Nursing Care if:
- you live in a nursing home
- you're not eligible for NHS Continuing Healthcare but have been assessed as needing care from a registered nurse
Most people don't need a separate assessment for NHS-funded Nursing Care. In Dorset, the nursing home will normally advise Dorset Clinical Commissioning Group that you need to be considered for NHS-funded Nursing Care. However, if you do think you need an assessment or you haven't already had one, your Clinical Commissioning Group can arrange an assessment for you. If your care home is in Dorset it will normally be Dorset Clinical Commissioning Group who will assess you for NSH-funded Nursing Care. Find your local Clinical Commissioning Group
NHS-funded Nursing Care is not means tested which means a financial assessment would not be required based on your income and/or savings.
Continuing healthcare assessment
Step 1 - initial screening
First of all, an NHS Continuing Healthcare Checklist is usually completed with you, or your family or representative, to see if you are likely to be eligible for this funding. This can be done in a variety of settings, except in hospitals, and must be carried out by a health or social care professional. You cannot refer yourself for this assessment, but you can ask your health or social care professional to complete a checklist and send it to the Clinical Commissioning Group. This process will assess your general health and care needs and the Checklist will cover:
- cognition (understanding)
- psychological and emotional needs
- nutrition (food and drink)
- skin including wounds and ulcers
- symptom control through drug therapies and medication
- conditions that affect consciousness such as seizures or TIA (mini-stroke)
- other significant care needs
Fast track assessment
If your health, or that of someone you care for, seems to be getting worse rapidly, ask your doctor, nurse, occupational therapist, or other health professional about completing a fast track assessment. This is a different form of CHC that provides a faster form of assessment in response to the health of a person rapidly deteriorating.
Step 2 - the assessment
If the NHS Continuing Healthcare Checklist indicates that you may meet the criteria for NHS Continuing Healthcare funding, a more detailed assessment will be carried out. This will be by a team of two or more health and social care professionals who are experienced and trained in undertaking CHC assessments. You will be part of the assessment as well as your family or representatives in addition to people who are involved in your care.
The team will cover the same areas as the NHS Continuing Healthcare Checklist above but will go into a lot more detail before the Clinical Commissioning Group makes its decision on whether you are eligible for NHS Continuing Healthcare.