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What is NHS Continuing Healthcare?

As our parents get older their healthcare needs can change considerably. With complicated health conditions comes lengthy NHS and local authority assessments that can leave both you and your parent in a state of confusion.

It can be difficult to understand how these processes can be of benefit to your parent but ultimately NHS Continuing Healthcare is there to help your parent manage their complex on-going health conditions and remain independent for longer.

How can NHS Continuing Healthcare help my parent?

Depending on the severity of your parent’s health condition they may be eligible for a wide range of healthcare services from the NHS as part of their Continuing Healthcare. This could include help with household chores, travel arrangements and accessing local day services as well as addressing their personal care needs such as washing and dressing etc.

How much does NHS Continuing Healthcare cost?

NHS Continuing Healthcare is completely free and based solely on your parent’s state of health and not their financial wellbeing. This is where it differs from accessing social and community care services offered by your parent’s local authority as these services are usually means tested. The local authority takes into consideration your parent’s assets such as their house and savings rather than just focusing on their healthcare needs.

Who pays for NHS Continuing Healthcare?

Since April 2014 your parent can ask to have their NHS Continuing Healthcare as a Personal Health Budget which means both you and your parent have a clear indication of how much money’s available to fund their care and can agree with the NHS how that money should be spent.

Alternatively your parent can access the money put aside for their Continuing Healthcare as a Direct Payment which means the money comes straight to them and they manage how it’s spent to cover their care needs.

If your parent was previously receiving payments from their Independent Living Fund (ILF) to pay for their personal care needs they should now be receiving NHS Continuing Healthcare via Direct Payments or their Personal Health Budget. The (ILF) is now closed to new applications.

Is my parent eligible for NHS Continuing Healthcare?

The Department of Health’s National Framework has determined the eligibility criteria for NHS Continuing Healthcare as:

  • Having a “primary health need”
  • And a complex medical condition
  • And substantial, on-going care needs

If your parent’s health needs fit with this criteria then the NHS is responsible for their nursing care, healthcare and accommodation costs, with no contribution from the patient or local authority.

While the above list can seem like a vague hat rick of health issues your parent should seek the advice of their GP or specialist to explain any terminology that they may not understand as well as the specifics of the assessment process.

What conditions aren’t eligible for NHS Continuing Healthcare?

Many medical conditions that we may deem “complex” aren’t considered eligible for NHS Continuing Healthcare including dementia, Alzheimer’s, arthritis and osteoporosis which will all be discounted as part of the assessment process.

If you’re unsure about your parent’s eligibility it’s best to ask their GP or care worker for advice before requesting an assessment. You may find that you or your parent’s carer will need to do much of the leg work yourselves to ensure their case is duly considered by their Clinical Commissioning Group (CCG).

What’s involved in an assessment?

To determine whether your parent is eligible for NHS Continuing Healthcare their CCG will assess their needs. Your parent’s consent and their views, along with yours (and their carer’s), should be obtained before the assessment takes place in order to create a comprehensive picture of your parent’s condition(s).

The CCG assessment is carried out using 1 or more of 3 assessment tools:

1. The Fast Track Pathway Tool is used for patients who have a rapidly deteriorating condition and/or appear to be entering the final phase of life. This is when your parent needs URGENT consideration.

2. The Checklist Tool is used when a patient’s assessment isn’t deemed urgent. This is a needs based assessment designed to help health and care professionals identify those most likely to be eligible for NHS Continuing Healthcare. The checklist enables full consideration of all your parent’s care needs – physical, emotional and mental. You and your parent can also request a copy of the checklist so you can further understand the assessment process and the decision that’s made based on the information recorded.

3. The Decision Support Tool is used by a multi-disciplinary team (MDT) of healthcare professionals to identify your parent’s health and social care needs in relation to 12 care domains. These domains are divided into levels which your parent’s MDT will match with their specific needs in order to build up a detailed analysis to inform the CCG’s eligibility decision.

When will my parent’s NHS Continuing Healthcare be reassessed?

Your parent’s healthcare needs can vary from time to time during the course of their life. After the first 3 months of your parent receiving NHS Continuing Healthcare their health needs will be reassessed and subsequently their eligibility for NHS Continuing Healthcare.

Your parent’s eligibility will then be reassessed every year to ensure that they’re getting the right level of support they need and to determine whether Continuing Healthcare is still warranted.

Can my parent access NHS Continuing Healthcare at home?

As long as your parent is eligible they’ll be able to receive NHS Continuing Healthcare in any setting that they, or you, choose. If you parent chooses to have care at home the NHS will pay for a community nurse or therapist to come and assist them with personal care needs or monitor their healthcare needs – checking on their medication dosage and ensuring their condition doesn’t worsen.

What if my parent’s in a care home?

If your parent’s living in a care home the NHS should provide help with their health and personal care needs (described above) as well as paying for their care home fees, including board and accommodation.

For more information on NHS Continuing Healthcare visit the NHS website or call Carers Direct on 0300 123 1053 for confidential advice on the care choices for your parent.

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