Most individuals in the UK must pay an amount towards the care they receive. However, some individuals who have significant ongoing health needs can have the NHS pay for their care through NHS ‘continuing healthcare’.
NHS continuing healthcare (CHC) or NHS ‘continuous healthcare’ is a government-funded care package for individuals who have been assessed to have a primary health need. All the care is arranged and paid for by the NHS, in this case.
Many people who have always wanted to know “What is NHS CHC?” should be familiar with these two aspects of NHS’s continuing healthcare process:
- If you will be receiving the care in your own home or place of residence, the NHS will cover the cost of the care administered and support you, in order to meet your assessed health and associate care needs. This includes personal care such as assistance with washing, for example, or getting dressed.
- If you are going to be receiving CHC or continuing healthcare in a care home or facility, then the NHS will pay your care home fees, and not pay you directly.
What is NHS continuing healthcare?
Within England, Northern Ireland, and Wales, if you have a disability or a complex health problem which requires ongoing assistance, then you may qualify for NHS continuous healthcare at no cost to you. The cost is covered entirely by the NHS and includes:
- Accommodation if your care is administered in a care home
- Support for carers if your care is being administered at your residence
- Covering costs associated with specialist therapy
- Assistance with washing and/or dressing
However, you do need to be assessed as having a ‘primary health need’, in which case, the NHS will be funding your care needs, even if you’re not admitted to a hospital. So, for example, you could be in a care home, hospice, or your own home, and the NHS will provide all the funding for your care needs.
How does the continuing healthcare process work?
In order to understand what is NHS continuing care and how the process works in general, you must first understand the eligibility criteria.
Ask your GP, social worker, or NHS CHC solicitor to arrange for an assessment in order to determine if you qualify for CHC (continuing healthcare). Your eligibility to get funding is based on your assessed needs, and not necessarily on a specific diagnosis, for example, or a certain health condition. If these assessed needs change, so will your eligibility.
Just to give you a better idea of the continuing healthcare process, you might quality if you have:
- Significant or major health needs because of an accident, illness, or disability
- Complex care demands which go beyond what social services or the local council can provide
- Post-hospital discharge which requires a high and persistent level of care
- An ongoing care review which has determined that your needs have changed or increased
When you qualify for NHS funded nursing care, your solicitor will work with you to arrange an appropriate care and support package which fully meets with your assessed needs. Depending on what those needs are, certain options might work better for you than others. This is why it is important to consult a CHC continuing healthcare solicitor at the first opportunity you get.
What does continuing health care mean?
The NHS’s ‘continuous health care’, also known as continuing healthcare, is an ongoing care package where funding is solely taken care of by them. If you are 18 years or older and have been found to have a ‘primary health need’ due to an accident, illness, or disability, then you can take advantage of the free funding.
With that in mind, your care package needs to meet your assessed health needs and this is where it can get tricky for most people.
Speak to one of our friendly, courteous, experienced, and professional solicitors who can help with assessing your needs and ensuring that you receive complete funding for the right ongoing care option.
How to get NHS Continuing Healthcare?
Gaining NHS Continuing Healthcare eligibility can be difficult. To qualify, you must demonstrate your needs are:
- Complex, intense or unpredictable;
- Not incidental or ancillary to the accommodation your local authority is under a duty to provide; and
- Not of a nature typically provided for by a social services department.
There are two key stages when applying for NHS Continuing Healthcare eligibility:
- Checklist assessment:
This is a screening tool which determines whether an individual’s needs warrant completing the Decision Support Tool.
- Completion of a Decision Support Tool (DST):
This is an assessment tool which is conducted to investigate whether an individual’s needs are primarily healthcare needs that would qualify for NHS Continuing Healthcare. The assessment looks at the full range of care needs, but focuses on 12 care domains which include cognition, behaviour, nutrition and mobility.
As part of the DST, the individual in question will be given a level of need in each of the 12 care domains. There are six levels, ranging from no needs to priority.
If a patient’s level of need is assessed as being priority in any area, eligibility for full funding is automatic (however you should note that the priority level of need is only applicable to four of the 12 care domains). If a patient’s level of need is assessed as being severe in any two areas, eligibility for full funding is also automatic.
It is still possible to be found eligible without a priority or two severe measurements, however the rules are open to interpretation. The higher the level of need, the more likely it is that an individual will be found eligible for NHS Continuing healthcare.
