NHS Continuing Healthcare – The Basics

If you have ongoing health problems which mean you need help the last thing you want to worry about is paying for it.  That’s where NHS continuing healthcare comes in.

If you qualify, NHS continuing healthcare will provide help in any setting, free of charge:

• Your Own Home – You may need treatment from a community nurse or therapist, but you can also receive help with day-to-day life, such as washing, dressing or laundry.
• A Care Home – If you need care not already provided by the care home this will be taken care of.  In addition, NHS continuing healthcare will pay your care home fees, including board and accommodation.

There is no means testing or part-contribution and it makes no difference who provides the care.  If you have a genuine ongoing healthcare need, it will be met without any cost to you or your relatives.

Do I Qualify for Continuing NHS Healthcare?

This can be a complicated decision but the basic principle is simple:

• If your main care needs are related to health (physical or mental) and require ongoing care you may be eligible.
• If your needs are more concerned with social or personal issues this will usually be dealt with by social services.  In this case any funding comes from your local authority rather than the NHS and means testing comes into play.

A simple question to ask yourself is who will be able to deliver the care you need.  If that person requires specialised medical knowledge, such as a registered nurse or therapist, then your needs are health-related and continuing NHS healthcare could be an option.  However, these needs are likely to be complex and require a lot of support – being disabled or having a long-term condition does not necessarily make you eligible.

In the real world, of course, people’s needs are complicated and it can be difficult to decide.  That’s why there is a careful assessment process to ensure people who genuinely need this help receive it.  In the end you may even receive ‘mixed services’ where continuing NHS healthcare meets some of your needs free of charge whilst social services provide others subject to means testing.

How Do They Decide?

This is a two-stage process.  Stage 1 essentially rules out people who are clearly not eligible, leaving stage 2 for the more detailed assessment.

The NHS Checklist Tool

The first stage is carried out by a health or social care professional.  They use the checklist tool – sometimes called a screening tool – to decide firstly whether your need is health-related and secondly whether it is serious enough to require NHS continuing healthcare.

The checklist tool could be used by a nurse or doctor before you leave hospital.  More usually, though, this happens in your own home, where your long-term needs are clearer.  It could also be completed by a social worker carrying out a community care assessment.

You won’t get an on-the-spot decision – your local primary care trust will write to you with the outcome of your NHS checklist tool assessment.  If that suggests you may qualify for NHS continuing healthcare you move on to the more detailed stage where the final decision is made.

The Decision Support Tool

This is a detailed process involving many people.  All the health and social care professionals involved in your care will make a contribution to the decision-making process so that a complete picture is built of your needs.  Sometimes more detailed specialist assessments may also be required.

The results of this process are applied to the decision support tool, which enables a final decision to be made.  This looks at eleven types of need:

• Behaviour
• Cognition (understanding)
• Communication
• Psychological/emotional needs
• Mobility
• Nutrition
• Continence
• Skin (including wounds and ulcers)
• Breathing
• Symptom control through drug therapies and medication
• Altered states of consciousness

In making their decision, your assessors will think about how complex your needs are, how severe your conditions and how unpredictable your problems may be.  Once the decision support tool has been completed your primary care trust will write to you with their decision.

After the Decision is Made

Whether you have been assessed as eligible for NHS continuing healthcare or not, that isn’t the end of the story.

If you have been granted continuing healthcare this decision will be reviewed regularly.  That means if your care needs change then your funding may change too.
If you were refused continuing healthcare you can ask for a review of that decision.  The primary care trust will look again at your case and if they still don’t believe you qualify you can ask your strategic health authority to review the process.

Support and Care

At Nobilis we understand the challenges faced by those needing care at home.  Often those challenges involve simply understanding the complicated world of support services and funding schemes.

That’s why we provide articles such as this to de-mystify areas that can leave people befuddled even on official NHS sites!  But we don’t pretend an online article can answer all your questions, so why not speak to a real person with experience and knowledge?

Our friendly team know exactly the issues you face and we’re ready to help with a chat.  No hard sell, no hidden agendas, no nonsense.  Our business is simply helping people so

if you need some advice give us a call on 0845 8620647