Continuing Health Care – independent review panels

Purposes for processing

NHS Continuing Healthcare is a package of care for adults aged 18 or over which is arranged and funded solely by the NHS. It is available to individuals outside of hospital who have on-going health needs. This package is often delivered in an individual’s own home or a care home. In order to receive NHS CHC funding individuals have to be assessed by Clinical Commissioning Groups (CCGs) according to a legally prescribed decision making process to determine whether the individual has a ‘primary health need’. NHS England is required to establish arrangements for the independent review of CCGs decisions on eligibility for NHS Continuing Healthcare funding.

An individual receiving care or their representative may apply for a review of a CCGs decision to decline funding by an NHS England Independent Review Panel. The independent review process is co-ordinated by the NHS Continuing Healthcare teams in each of the four regions of NHS England.

Sources of the data

The personal data are submitted by the CCG and the applicant for review.

Categories of personal data

The information CCGs use to assess eligibility, and which may be submitted to an Independent Review Panel, fall under the following headings:

  • behaviour
  • cognition (understanding)
  • communication
  • psychological/emotional needs
  • mobility
  • nutrition (food and drink)
  • continence
  • skin (including wounds and ulcers)
  • breathing
  • symptom control through drug therapies and medication
  • altered states of consciousness
  • other significant needs

The obtained records that relate to these areas may include Care Home records, Health Records (for example GP, Hospital, Mental Health, District Nursing) and Social Care Records.

Categories of recipients

Personal data relating to the application is received by NHS England Continuing Healthcare teams and the members of the review panel. An Independent Review Panel is made up of:

  • an independent chair
  • a representative nominated by a Clinical Commissioning Group (not involved in the case);
  • a representative nominated by a Local Authority (not involved in the case); and
  • at times there is also a clinical advisor in attendance.

Legal basis for processing

For GDPR purposes NHS England’s lawful basis for processing is Article 6(1)(e) – ‘…exercise of official authority…’. For the processing of special categories (health) data the basis is Article 9(2)(h) – ‘…health or social care…’.