NHS Continuing Healthcare means a package of on going care that is arranged and funded solely by the National Health Service (NHS) specifically for the relatively small number of individuals (with high levels of need) who are found to have a ‘Primary Health Need’ (see more in Primary Health Need section below). Such care is provided to an individual aged 18 or over to meet health and associated social care needs that have arisen as a result of disability, accident or illness.
NHS Continuing Healthcare (CHC) is free, unlike support provided by local authorities, which may involve the individual making a financial contribution depending on income and savings. It is the responsibility of the Clinical Commissioning Group (CCG) to decide the appropriate package of support for someone who is eligible for NHS Continuing Healthcare (CHC).
- What is NHS Continuing Healthcare?
- Who is eligible for CHC?
- How is CHC assessed?
- Children's and young people's CHC
- Personal Health Budgets
1. What is NHS continuing healthcare?
NHS continuing healthcare (CHC) is NHS funded care provided outside of hospital. It is arranged and funded by Clinical Commissioning Groups (CCGs) for people aged 18 years and over who have significant ongoing healthcare needs who are either receiving long-term care or who may be at the end of their life and need care and support to meet their palliative care needs.
To establish whether a person is entitled to have their care paid for with NHS CHC, they first need to be assessed to determine whether they have a Primary health Need and are therefore eligible to receive NHS CHC funding. The process to determine eligibility is nationally defined, so we follow a standard process and use standard assessment tools to collect information to decide whether someone is eligible. The national assessment tools can be found here.
2. Who is eligible for CHC?
There is a National Framework which states that eligibility should be based on someone’s healthcare needs and not their diagnosis. It is not linked to savings or income levels.
Many people who are assessed for CHC are reaching the end of their lives or face a long-term condition, because of a disability, accident or illness. They can have a wide range of healthcare conditions and may receive funding for just a few weeks or many years.This includes people with physical disabilities, learning disabilities, older adults with complex physical and psychological needs as well as young people transitioning from childhood to adulthood who become entitled to receive NHS CHC, if eligible, at the age of 18.
NHS CHC is not forever, only for as long as someone has complex care needs that result from their having a primary health need.
3. How is CHC assessed?
For most people, the assessment process for CHC involves an initial screening and then a full assessment. After the full assessment, a recommendation will be made to the Clinical Commissioning Group (CCG) about whether the patient is eligible.
The initial screening is usually carried out by a health or social care professional who knows the individual and uses the checklist to decide whether people need a full assessment. The person who completes the Checklist will send it to the CHC team.
The full assessment is usually carried out by a registered nurse employed to work for the NHS along with a group of health and social care professionals who have been involved in the patient’s care. They are known as a multidisciplinary team (MDT). Health and social care professionals must use their professional judgement at both the screening and full assessment stages when undertaking an assessment. They will consider the person’s combined healthcare needs across 11 domains (areas of need) to complete an initial checklist and across 12 domains to undertake the full assessment.
The multidisciplinary team will then make a recommendation to the clinical commissioning group (CCG) about whether the person has a Primary Health Need and is eligible and the CCG will make the final decision.
In Derby and Derbyshire this assessment is led by staff employed by Midlands and Lancashire Commissioning Support Unit (MLCSU).
People will be assessed three months after their successful assessment and then annually. This is to ensure that the care provided is still relevant and providing the right support, as well as ensuing that continuing healthcare is still needed
4. Children and Young peoples’ Continuing Care
NHS continuing care is support provided for children and young people under 18 who need a tailored package of care because of their disability, an accident or illness. It is different from NHS continuing healthcare, which can be provided to adults who have very severe or complex health needs.
The main difference is that while continuing healthcare for adults focuses mainly on health and care needs, continuing care for a child or young person should also consider their physical, emotional and intellectual development as they move towards adulthood.
This means that if your child is assessed for NHS continuing care, it is likely that a range of organisations will be involved, such as health, education and local authority children’s services. These different agencies will contribute to your child’s care package if they are found to have continuing care needs.
If you think your child should be assessed for NHS continuing care, talk to a health or social care professional who works with them. They will make a referral to Derby & Derbyshire Clinical Commissioning Group if appropriate.
Information on children and young people’s Continuing Care
Information on children and young people’s continuing care can be found at:
Guidance for professionals
5. Personal Health Budgets and CHC
If you’re eligible for NHS continuing healthcare, you have the right to a personal health budget (PHB). These allow more choice and control over the services and care you receive and can be used to pay for a wider range of items and services, including therapies, personal care and equipment.
A PHB is an amount of money to support your individual health and wellbeing needs, as agreed between you and your local NHS team. Your health and wellbeing needs will be set out in a personal centred care and support plan which will be developed by you together with a health care professional. How the budget will be used to support your health and well-being needs will be set out in this plan and agreed by both yourself and the local NHS team.
Arrangements for managing this budget will be agreed between yourself/ your representative and the CHC team.
Personal health budget support the vision of a more personalised, patient-focused NHS. NHS England's website has more information and advice about the new scheme. Find out more about personal health budgets on the NHS website.
Currently, only individuals in receipt of NHS continuing healthcare (CHC), and in the case of children and young people, continuing care, have the right to have a personal health budget - although CCGs can offer personal health budgets to other groups if appropriate.
Derby and Derbyshire CCG also offer Non-CHC PHBs to anyone eligible adult or child. For more information on PHBs please click here.
How to contact NHS CHC
Anyone can ask for a CHC assessment
If you feel that you, a family member or someone you care for might be eligible for NHS CHC, then you can speak to:
- a member of the clinical team involved in your/their care
- your social worker (if applicable)
- contact the CHC team
3rd Floor North Point,
10 Nottingham Road,
Derby DE1 3QT
Tel: 01332 888231 firstname.lastname@example.org
Our website is: https://www.midlandsandlancashirecsu.nhs.uk/