NHS Gloucestershire Continuing HealthCare (Commissioning) service is based at the NHS Gloucestershire CCG, Sanger House, Brockworth.
What is NHS Continuing Healthcare?
NHS Continuing Healthcare is the name given to a package of care which is arranged and funded solely by the NHS for individuals, aged 18 years and over outside of hospital that have ongoing complex or intense or unpredictable healthcare needs. NHS continuing healthcare can be provided by the NHS in any setting, including a care home or at home.
Eligibility for NHS Continuing Healthcare is not dependent on any particular disease, diagnosis or medical condition. Eligibility is assessed through a process as defined in the Department of Health National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care.
How do I know if I am eligible?
The first step in the process for most people will be a screening process, using the NHS Continuing Healthcare Checklist. This will be completed by a social worker or NHS health professional, usually involving you or, if you choose, your family, carers or representative. Where the Checklist indicates that you may have needs that would make you eligible for continuing healthcare, a referral to the Continuing Care team for a full and comprehensive assessment of eligibility will take place.
To determine a person’s needs a comprehensive health needs assessment is completed by multi-disciplinary health and social care professionals, using the Decision Support Tool. The Decision Support Tool is not an assessment in itself but helps bring together information in a single format to facilitate decision making regarding NHS continuing healthcare eligibility.
What happens after the assessment?
The health and social care professionals will make a recommendation to Gloucestershire Clinical Commissioning Group (CCG) about your eligibility for NHS continuing healthcare. The CCG will then write to you advising whether you are eligible, giving reasons for their decision. In most cases, the decision will be made within 28 days of the CCG receiving the Checklist Tool.
What happens if I am assessed and deemed not eligible for NHS Continuing healthcare?
You should wait for written confirmation of the outcome of the assessment. If you are unhappy with the outcome, you should firstly speak to the Continuing Healthcare Nurse Assessor handling the case and ask for an informal meeting. This will allow you to discuss areas of concern and obtain clarification where needed. If you are still unhappy, the CCG has a review process which the Nurse Assessor will explain to you.
Where is NHS continuing healthcare provided?
NHS continuing healthcare can be provided by the NHS in any setting, including a care home or at home. If NHS continuing healthcare is provided in a care home, it will cover the care home fees, including the cost of accommodation, personal care and healthcare costs. If NHS continuing care is provided in the home of the person, it will cover personal care and healthcare costs. Those in receipt of NHS continuing healthcare continue to be entitled to access to the full range of health services. This means, for example, GP, Hospital, out-patients, District nursing.
What if my care needs change?
If you are assessed as eligible for NHS continuing healthcare, you need to know that it is subject to review and should your care needs change the funding arrangements may also change. Your eligibility for NHS continuing healthcare will be reviewed regularly. If you are not eligible at this assessment, you may be eligible at a later date should your needs change over time. you can ask for a reassessment or ask your social worker, health worker or nursing home to refer you.
What is Funded Nursing care
If you are not eligible for NHS continuing healthcare, but are in a nursing home (a care home that is registered to provide nursing care), you may be eligible for NHS-funded nursing care. This means that the NHS will pay a contribution towards the nursing home fees, previously known as the Registered Nursing Care Contribution (RNCC). The NHS will make a payment directly to the care home to fund care from registered nurses who are usually employed by the care home.
What is the Fast-Track tool?
This tool should be used where an appropriate clinician considers that a person should be fast tracked for NHS Continuing Healthcare because that person has a rapidly deteriorating condition and the condition may be entering a terminal phase. The person may need NHS Continuing Healthcare funding to enable their needs to be urgently met (e.g. to enable them to go home to die or to provide appropriate end of life support to be put in place either in their own home or in a care setting).
Personal Health Budgets
From April 2014 anyone eligible for CHC wanting to have their care provided outside of a care home setting, will be able to receive the money they need to meet their healthcare needs as a Personal Health Budget, in the form of a Direct Payment. This will give people a greater choice over how, when and who provides their care and support. A Personal Health Care Budget can be discussed in detail with the Nurse Assessor responsible for your assessment.
The Department for Health also publishes a public information booklet on both continuing healthcare and funded nursing care.
If you would like more information
If you would like further information on Continuing Healthcare you can contact the Continuing healthcare team either by telephone or in writing to:Continuing Healthcare Sanger House 5220 Valiant Court Delta Way Gloucester Business Park Brockworth Gloucester GL3 4FE
Tel: 0300 421 0302
Fax: 0300 421 1213
Office hours are 09.00am to 17.00pm Monday to Friday
Alternatively you can speak to your GP, health or social care professional.