NHS England » NHS continuing healthcare explainer video transcript

This animation will take you through the National Health Service Continuing Healthcare process, also known as NHS CHC.

What is NHS CHC?

NHS CHC is a package of care, arranged and funded by the NHS, that you may be entitled to receive, due to disability, accident, or illness. Eligibility for NHS CHC is not dependent on a particular disease, diagnosis or condition, nor on who provides the care or where that care is provided. It is for a relatively small number of people aged 18 and over with high levels of need (called a primary health need).

If you are under 18, there is a separate framework for Children and Young People’s Continuing Care, which is not covered within this video.

How does the NHS CHC process work?

There are several stages in the NHS CHC process. These are: assessing eligibility, planning your care package and regular reviews. It is important that at each stage you and your needs are put at the centre of the process.

Your local integrated care board, or ICB, is the NHS organisation responsible for arranging for the provision of health services in your area.

They have a duty to assess and decide if you might be eligible for NHS CHC and, if you are, to then work with you to agree the appropriate care package to meet your assessed needs.

Stage 1: the NHS CHC checklist

The assessment process usually starts with a screening process called the checklist, completed by a trained health or social care professional.

The checklist covers various aspects of your health and care needs and helps to show if you require a full assessment for NHS CHC.

The checklist will be offered to a lot of people to see whether they need a full assessment for NHS CHC. It is important to be aware that the majority of people who have a positive checklist, are found not to be eligible for NHS CHC once the full assessment has been done. If the checklist is negative and you disagree with this, you can ask the ICB to reconsider.

Stage 2: NHS CHC full assessment

If the checklist is positive, a multidisciplinary team, or MDT, will then carry out a full assessment.

The MDT is a team of at least 2 people from different healthcare professions, or 1 healthcare professional, and 1 person responsible for adult social care assessments.

Where possible, the MDT should have been involved recently in your assessment, treatment, or care.

The team will talk to you, and if you agree, other people who support you, including a relative, friend or advocate, can sit in the assessment with you. They will review your medical and care records and gather information from other professionals and specialists involved in your care. They will consider all aspects of your needs in relation to 12 care domains, for example breathing, mobility and nutrition.

You should be invited to attend and participate in the MDT meeting. This meeting may happen face-to-face, or virtually. You can discuss with the ICB how the MDT meeting is held.

The MDT will complete the decision support tool, or DST. This helps the team decide whether they think you have a primary health need. To guide this decision, the team will look at all your relevant needs in relation to 4 key characteristics: nature, intensity, complexity, and unpredictability.

The MDT then recommends to the integrated care board whether you are eligible for NHS CHC or not. The ICB should usually accept the MDT’s recommendation.

The NHS CHC assessment process should, in most cases, take no longer than 28 days.

If you are eligible for NHS CHC, the NHS becomes responsible for meeting your needs, any support from existing local authority arrangements will draw to a close.

If you are not eligible for NHS CHC you can ask your ICB to review its decision. Your ICB should tell you how you can do this. You could be eligible for funded nursing care, provided by the NHS to care homes with nursing. Alternatively, you could be eligible for joint care packages of care, where the NHS may pay for part of the package of support. These are described later on in the video.

Stage 3: Planning support

If you are eligible for NHS CHC, your local ICB is responsible for planning and sourcing your package of support based on your needs. This includes what help you get each day, where that support will be given and who will deliver it. Your wishes should be at the heart of your care plan and package of support. You may choose to have a personal health budget. You can find out more about this at www.england.nhs.uk/personalhealthbudgets.

Stage 4: Reviews

If you are eligible for NHS CHC, you should have a review within 3 months of the eligibility decision to make sure that you are getting the support you need. Further reviews should be undertaken at least once a year and may be more frequent depending on your needs.

The main focus of these reviews should be on whether the care plan still meets your needs. Sometimes, this may mean that a reassessment of your eligibility for NHS Continuing Healthcare, with a multidisciplinary team, is required.

Fast track pathway tool for NHS CHC

The NHS CHC fast track pathway is for people with rapidly deteriorating conditions who may be entering a terminal phase of their life. They require quicker access to NHS CHC funding. This is instead of the full NHS CHC assessment process.

In these cases, a single referral form, called the NHS CHC fast track pathway tool, is completed by an appropriate clinician to establish your eligibility for NHS CHC and this is then sent to the ICB.

There are several ways in which care might be provided at the end of your life, which may be appropriate within local health and care systems. Not everyone at the end of their life will be eligible for or require NHS CHC.

NHS-funded nursing care (FNC)

If you are not eligible for NHS Continuing Healthcare, you may be eligible for funded nursing care.

FNC is the funding provided by the NHS to care homes with nursing. This funding is a standard rate contribution to support the provision of your care by a registered nurse if you are assessed as eligible for FNC.

Your eligibility for NHS CHC should always be considered before a decision is reached about your need for FNC.

Joint packages of care

If you are not eligible for NHS CHC but still have some health needs, then the NHS may still pay for part of your package of support.

This is known as a ‘joint package of care’. One way in which this is provided is through FNC. The NHS might also provide other funding or services to help meet your needs.

Whether or not you are eligible for NHS CHC, you are still entitled to make use of all the other services from the NHS in your area in the same way as any other NHS patient.

Summary

We hope this video has helped you to understand more about NHS CHC and how it works.

If you think that you or a friend or family member should be considered for NHS CHC, speak to your local health or social care professional.

If you would like more information about NHS CHC, you can contact your local ICB’s NHS CHC team or refer to the information available on the NHS website.

You can find your local ICB at this website https://www.nhs.uk/nhs-services/find-your-local-integrated-care-board/

You can also request a transcript of this video via email on england.aaccprogramme@nhs.net

You can find further information about NHS CHC on the websites listed on screen now:

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