NHS Continuing Healthcare provides a framework within which each person can be assessed to receive support for a Primary Need for care at home, in a care facility or hospital. The assessment begins with a checklist that determines the eligibility of a person to be provided Continuing Healthcare.
The checklist must be completed by a healthcare professional. This could be a nurse, medical doctor or social worker who is currently involved with the care of the individual being assessed. A blank Assessment Checklist can be downloaded at the official NHS Continuing Healthcare website.
The checklist is made up of 12 main categories to be assessed according to severity, complexity and the type of assistance or support that is needed. The categories include:
– Behavioural Needs
– Cognitive Needs
– Communication Needs
– Emotional and Psychological Needs
– Mobility Needs
– Dietary and Nutritional Needs
– Continence Needs
– Skincare Needs (including ulcers, wounds, etc.)
– Respiratory or Breathing Needs
– Drug Therapy or Medication Needs for Symptom Control
– States of Consciousness
– Any other needs that may contribute to eligibility for NHS Continuing Healthcare.
Each category must be rated according to the severity of the need of the individual using the following scale of reference:
– No Need
An integrated approach is taken in determining eligibility for a full assessment and all the categories are taken into consideration together rather than as an isolated need. However, where one category is rated as a priority, an assessment will be recommended. Where two categories are listed as severe, an assessment may also be recommended.
The healthcare professional or social worker evaluating the needs of an individual will decide whether to recommend a full assessment or not and must provide reasons for their recommendation. Being recommended for an assessment does not however mean that a Continuing Healthcare benefits package will be provided but only that a full assessment will be conducted.
Once the checklist has been submitted with the recommendation from the healthcare professional, a CCG (Clinical Commissioning Group) will be established consisting of two medical carers who are currently involved in the care of the person as well as a team coordinator. This team will then assess the needs for care of the person requiring care and deliver a decision within 28 days of starting the assessment process.
Should a person not be eligible for NHS Continuing Healthcare, the can contact a local authority to discuss other care options that are available to them. Should the need for care be urgent, they can apply for a fast-track assessment that will provide a decision within 48 hours.
It is very important to note that a NHS Continuing Healthcare assessment is based on the need for care rather than the severity of an illness, injury or disability that has resulted in the need for care. Therefore, it is not the severity of the condition that is assessed but rather the need for care. For example, a person who has been diagnosed with a life threatening illness but is not in immediate need of care may not be eligible for NHS Continuing Healthcare.