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Continuing Healthcare

NHS Continuing Healthcare

Sometimes complex long-term care needs mean that it’s hard to determine whether they are the responsibility of the NHS (and therefore free) or of social services (and therefore means tested).  Naturally this can have significant financial consequences.

Due to a whole series of complaints about previous outcomes, the National Framework for NHS continuing healthcare and NHS-funded nursing care was developed and first introduced in England in October 2007.

NHS continuing healthcare is a package of care arranged and funded by the NHS to meet health needs that have arisen due to disability, accident or illness where the care is provided in any setting.   If this is in your own home then the NHS will arrange and fund all relevant fees.  If you live in a care home the NHS makes a contract with the home to pay fees covering your accommodation and assessed health and personal care needs.

Reasonable steps must be taken to ensure that all cases are assessed for eligibility for NHS continuing healthcare and although not everyone with ongoing health needs is likely to be eligible you should speak with your GP or social services if:

• you are ready to be discharged from hospital and are not being offered rehabilitation or other NHS-funded services that may lead to an improvement in your condition

• your physical or mental health has deteriorated significantly and your current level of care seems inadequate

• you are already living in a nursing home and your nursing care needs are being reviewed

• you are experiencing an increasing level of dependency and may be approaching the end of your life

When determining eligibility staff should follow the Framework guidance and it is a responsibility of the local authority to ensure that you are an active participant in this process and that you are fully involved in the assessment.  You must be able to articulate your preferences and choices and government guidance confirms that your views and wishes must be kept at the centre of all decisions that are made.  

Once eligibility is determined you should receive confirmation as a clearly written statement declaring what your needs are, how they will be met, and which organisations or individuals will be involved in meeting those needs. This statement is called the Care Plan.  

If you are unhappy with the result of the assessment, or how it was carried out, then you can make a complaint. All local authorities have a straightforward complaints procedure and you can contact your social services department for details. If you need help or advice with making a complaint your local Citizens Advice Bureau or Age Concern group may be able to help you. The packages of care provided by Local Authorities are regularly reviewed and you can ask for a reassessment at any time. More information regarding the complaints procedure can be found here:
www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_106229.pdf

If it’s determined that you aren’t eligible for NHS Continuing healthcare, the NHS is still responsible for any care provided by NHS registered nurses.  This contribution to their cost is called NHS Funded Nursing Care. Most care homes will deduct this payment from their charges but as there is no standard procedure in place so it’s advisable to check with each individual Home as to their particular practice of dealing with this cost contribution.

 
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