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1 July 2022 | Comment | Article by Michelle Evans

New national framework for NHS Continuing Healthcare – here’s what’s changed

In May 2022, the Department of Health and Social Care published a revised National Framework for NHS Continuing Healthcare (CHC) and NHS Funded Nursing Care to come into effect on 1 July 2022.

The National Framework sets out the principles and processes for deciding eligibility for CHC in England.

NHS continuing healthcare is an ongoing package of health and social care that is arranged and funded solely by the NHS where an individual is found to have a primary health need.

The National Framework also contains a number of tools to assess for CHC eligibility:

The revision to the Framework coincides with a structural change within the NHS in England. Currently, clinical commissioning groups (CCGs) are responsible for assessing, funding and commissioning care for individuals. However, from 1 July 2022 this responsibility will be taken over by Integrated Commissioning Boards (ICBs).

The Health and Care Act 2022 establishes ICBs as the statutory bodies responsible for CHC. This is the biggest change to the structure of the NHS in England since CCG’s replaced Primary Care Trusts in 2013. The main reason for this change is to encourage greater integration between the NHS and other agencies such as social services. Whether this will be the result remains to be seen.

If you need advice about a nursing care assessment, care fees or another related matter, contact our team of leading experts today.

Since its introduction in 2007 the National Framework has been revised a number of times. In 2007, 2009, 2012 and lastly in 2018. None of the previous revisions made significant changes to the way CHC is assessed or the primary health needs test and this is also the case with the 2022 revision.

The main purpose of this revision seems to be to reflect the structural changes within the NHS and replaces any reference to CCGs with ICBs. There are however a number of changes that are worth noting.

Firstly, the revised framework provides more information and guidance around consent and making best interests decisions. The details of this can be found at paragraphs 73 to 96 of the revised framework.

The revised framework has also firmed up its previous guidance regarding when to assess for CHC eligibility. It is now very clear that an individual should not be assessed in an acute hospital setting. Assessments should be undertaken when an individual’s ongoing needs are known.

How our Nursing Care department can help

If you feel that you or your relative should be assessed for NHS continuing healthcare, or you feel that the correct procedures have not been followed by the NHS, please contact our nursing care department who may be able to request an assessment on your behalf. Our Nursing Care department will undertake a free no obligation assessment of your case.

We are the leading national experts in recovery of wrongly paid nursing fees and have recovered over £200 million in wrongly paid care homes fees. You can contact the team on 0800 988 2373 or complete our enquiry form.

Author bio

Michelle is a Senior Associate in the niche area of continuing healthcare, and has represented many clients, in both England and Wales, in challenging current and retrospective decisions to refuse NHS funded continuing healthcare to long-term nursing home residents.

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