NHS Continuing Healthcare

What is NHS Continuing Healthcare?

The NHS was created out of the ideal that good healthcare should be available to all, regardless of financial circumstances. This principle remains in place and NHS Continuing Healthcare provides comprehensive support for those with ongoing physical or mental health needs as a result of disability, injury or illness.

NHS Continuing Healthcare is fully funded by the NHS and is wholly free of charge to the person receiving care. This is sometimes referred to as "fully funded NHS care". It’s possible to receive NHS Continuing Healthcare even if you have a large amount of wealth or have received a compensation award towards the future cost of your care. 

NHS Continuing Healthcare is available in various settings, including in an individual's own home, or in a care home.  The NHS will either provide services direct or a payment to cover the cost of the services required to meet your care needs. Everyone who is eligible for NHS Continuing Healthcare has a right to request a direct payment to cover the cost of their care so that they can secure their own care services.    

The assessment Process

The assessment process for NHS Continuing Healthcare is both lengthy and complex. Those who qualify as being eligible for NHS Continuing Healthcare tend to be people with a very high level of healthcare needs requiring support and assistance on an ongoing basis.

An initial checklist tool is completed to decide whether you should be referred for a full assessment. This is usually undertaken by a nurse, social worker or other qualified individual when assessing your need.

If it appears that you may qualify, you will be referred to your local NHS Clinical Commissioning Group (CCG) who will then arrange a full ‘Decision Tool’ assessment to be carried out. Although the same Decision Tool assessment is carried out wherever you live in the country, the assessment criteria are not always applied in a consistent way. It’s important that you seek advice about the process involved to ensure that the assessment is carried out correctly and that you have every opportunity to fully demonstrate the ongoing impact of your care needs on your day to day life.

The completion of the ‘Decision Tool’ assessment will require input from other professionals such as your GP who will provide evidence in relation to your care needs.  A multi-disciplinary team meeting (MDT) will be arranged to provide the various people involved in your care with an opportunity to review and assess your care needs before a final decision is made by your local NHS CCG.

 It’s essential that you have the right people involved to provide evidence as part of this assessment process to maximise the chances of you being assessed as being eligible for NHS Continuing Healthcare.

How can we help?

Hyphen Law can:

  • Advise you in relation to the NHS Continuing Healthcare assessment process
  • Advise you on how to gather evidence to demonstrate the level of your care needs and the type of evidence required
  • Initiate the NHS Continuing Healthcare assessment process
  • Make sure that you have the appropriate professionals involved to provide evidence as part of the assessment process
  • Attend the MDT meeting and ensure that the Decision Support Tool is completed correctly
  • Liaise with the NHS in relation to any issues which may arise and challenge points throughout the process where necessary

If eligible for NHS Continuing Healthcare we can:

  • Negotiate with the NHS over the services to be made available to you or the size of your direct payment
  • Advise you on the options available for either NHS services or a direct payment 
  • Assist you to put services in place and manage a direct payment on your behalf
  • Assist you to directly employ support workers and deal with your ongoing obligations as an employer
  • Report to the NHS about how your direct payment is being spent
  • Attend NHS Continuing Healthcare review meetings and seek increases to your package where appropriate

The provision of NHS Continuing Healthcare can be life changing. It’s vital to ensure that your eligibility is properly assessed and that the right support is put in place to meet your needs.

Talk to us and find out how we can help.