NHS Continuing Healthcare
Also known as ‘Fully Funded NHS Care’, this is a complete package of health and social care arranged and funded by the NHS for people with continuing health needs, allowing this care to continue outside hospital. The package is free, with no requests made for personal contributions from the individual.
Who is eligible for it?
NHS Continuing Healthcare (NHS CHC) may be offered based on an assessment of the individual’s needs, and whether or not this constitutes a ‘primary health need’. This assessment is based on the following:
- The nature of their needs, referring to the impact on the individual, and the care needed to address them
- The complexity of their needs
- The intensity of their needs, referring to both quantity and degree
- The unpredictability of their health, and the potential impact of changes in their health.
An individual may be judged eligible for Continuing Healthcare based on one or a combination of the above factors. Upon being assessed as such, the NHS becomes responsible for funding and if necessary arranging all of their health-related care and support.
CHC is only offered to people over the age of 18. For those younger than this, responsibility for funding may be shared between the NHS, social care, and education.
The NHS has online guide to this assessment of eligibility.
Whilst it is the NHS that decides on the level of funding to be assigned, the individual has the final word as to which services and forms of care they are to be given and has the right of refusal. There are three main choices as to how this control is exercised.
- The NHS can be instructed to organise all aspects of the necessary care. The individual may choose to be involved in the planning stages, and any decisions and final plans will be subject to their approval. This is also known as a ‘Notional Budget’.
- The NHS can be instructed to pay for an independent third-party organisation to manage these care plans. Again, the individual chooses the level of their own involvement.
- If the individual lives within a Personal Health Budget pilot site, then they may be able to receive their budget as a Direct
Payment, giving them a much greater level of independence and responsibility over their own care. This option should be available nationwide from April 2014.
The chosen model should be person-centred, giving weight to the preferences of the individual. The NHS is required to provide a package appropriate to the needs of the individual, and will usually go for the lowest-costing option. This can be challenged, however, should it be arguable that the wishes of the individual are not being catered for. For example, someone wishing to be cared for at home may be receive budgeting to allow them to do so, instead of being placed in cheaper residential care.
If the person is living in a residential care home, then the NHS would become responsible for their accommodation costs. If they are living at home, however, then the NHS would have no responsibility for meeting costs of daily living, such as rent, food or electricity. Social security benefits for a person living at home would remain unaffected, but any Independent Living
Fund money would stop.
The local council would not provide funding for any services which fall under the remit of NHS CHC, but they can be asked to provide support for independent living, such as access to community facilities.
Efforts are being made to combine several of the different streams of health and social funding into one package. Social care Personal Budgets and Personal Health Budgets may all be taken as Direct Payments. Transferring any existing streams of support and funding into NHS CHC should be done without disrupting any standing arrangements.