NHS Continuing Healthcare (CHC) is a complete package of on-going care provided to adults aged 18 or over, who have physical or mental health needs which have arisen as the result of disability, accident or illness. The package of care is arranged and funded solely by the NHS, and is therefore free at the point of delivery.
Care need not be provided in a nursing or residential care home, it can be provided in any appropriate setting including the person’s own home.
Where an individual is eligible for NHS Continuing Healthcare, the NHS is responsible for care planning and commissioning services to meet the assessed needs of that individual.
The services commissioned must include on-going case management for all those entitled to CHC funding, as well as for the NHS elements of joint packages, including review and/or reassessment of the individual’s needs.
At present, approximately 44,924 people receive CHC funding in England. All of these people will have been assessed using eligibility criteria set out in the National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care, which relates to England only.
Assessment Tools are used to ensure that there is a structured decision making process to determine whether the patient has care and support needs that are intense, complex and/or unpredictable, or have needs that are clearly beyond the remit of local authority social services to provide.
From 1st April 2013, the legal requirements on Primary care trusts to undertake the assessment process for CHC, transferred to clinical commissioning groups (CCGs). The challenge given the recent overhaul in this area is to ensure a smooth transition to commissioning by CCGs retaining skills within the system and providing more personalisation for patients.
It is clear within the National Framework that the individual and their representative, where appropriate, should be enabled to play a central role in the assessment process and emphasis is placed on the same being open, transparent and ‘person centred’.
Part of the CCGs responsibility is to manage cost and budgets and in attempt to try and reduce the time that NHS professionals are involved in the assessment process and therefore saving a further cost, some CCGs have adopted an approach for the future delivery of the assessment process whereby the assessment takes place without family or representatives’ involvement with views not being able to be put forward until after a decision has been made by the professionals. The problem with this approach is that an opportunity to have crucial information regarding the individual being assessed can be lost.
This may occur for example where the person being assessed has dementia and may have lost their mental capacity and is therefore unable to contribute to the assessment. This can make it difficult to ascertain as to whether the assessment has been carried out correctly or that the assessment fully and appropriately reflects the full extent of the care needs of the individual being assessed.
The National Framework states that the assessment process should be ‘open and transparent’. We therefore work closely with individuals, families and carers to ensure that all of the needs of the individual are recognised and recorded within the assessment documents.
At WBW Solicitors, Advocacy services are provided with the best interests of the individuals at the forefront of concern ensuring that there is fairness and equity as detailed within the National Framework.
If you or a loved one has been affected by the issue raised in this article, please contact Portia Woodhouse, who would be pleased to assist you on 01626 202 404.