About NHS Continuing Healthcare
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Understanding NHS Continuing Healthcare (CHC) NHS Continuing Healthcare (CHC) is a fully funded care package for adults with significant ongoing health needs due to disability, illness, or injury. Unlike social care, CHC is not means-tested, meaning financial status does not affect eligibility. Who is Eligible? Eligibility for CHC is based on care needs, not a specific diagnosis or condition. To qualify, an individual must have a primary health need, meaning their care is primarily focused on managing and preventing health issues rather than social support. What Does CHC Cover? CHC provides free care at the point of delivery across various settings: • In care homes – Covers all care fees, including accommodation. • At home – Covers nursing, personal care, and related household costs. • In hospices – Provides palliative and end-of-life care. The Assessment Process The CHC assessment begins with an initial screening using the Checklist Tool, conducted by a health or social care professional. This screening takes place when an individual is discharged from hospital, placed into care, receiving care at home, or experiencing changes in their health needs. The Checklist helps determine whether a full assessment is needed. If the Checklist indicates significant health needs, the individual is referred for a full assessment using the Decision Support Tool (DST). A multidisciplinary team (MDT) reviews the individual’s care needs across twelve domains, assessing their impact on daily life. The team then determines whether the person meets the criteria for NHS Continuing Healthcare. Key Characteristics of Eligibility • The assessment focuses on four key characteristics: • Nature – The type and impact of health needs. • Intensity – The level of care and support required. • Complexity – How different health needs interact. • Unpredictability – The likelihood of sudden changes or deterioration. • These characteristics determine whether the individual’s care is primarily health-focused, qualifying them for NHS CHC. Challenging CHC Decisions If CHC funding is denied, the decision can be challenged under the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. This framework outlines the assessment principles and provides a process for appeals, ensuring individuals with a primary health need receive the appropriate level of NHS-funded care. Many people are unaware of CHC funding and are often wrongly told they must pay for their care, leading to unnecessary means-testing. Anyone receiving full-time care with health-related needs should be assessed to determine their eligibility for this essential support. |
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