What is Continuing Healthcare?
NHS continuing healthcare is the name given to a package of care that is arranged and funded solely by the NHS for individuals outside of hospital who have ongoing healthcare needs. You can receive NHS continuing healthcare in any setting, including your own home or in a care home. NHS continuing healthcare is free, unlike support provided by local authorities for which a financial charge may be made depending on your income and savings.
If you are found to be eligible for NHS continuing healthcare in your own home, this means the NHS will pay for healthcare (e.g. services from a communtiy nurse or specialist therapist) and associated social care needs (e.g. personal care and domestic tasks, help with bathing, dressing, food preparation and shopping). In a care home, the NHS also pays for your care home fees, including board and accommodation
Who is eligible for Continuing Healthcare?
Anyone over 18 years of age assessed as having a certain level of care needs may be entitled to NHS continuing healthcare. It is not dependent on a particular disease, diagnosis or condition, nor on who provides the care or where that care is provided. If your overall assessment of care needs shows that you have a 'primary healthcare need', you should be eligible for NHS continuing healthcare. Once eligible for NHS continuing healthcare, your care will be funded by the NHS, this is, however, subject to regular reviews, and, should your care needs change, the funding arrangements may also change.
Whether someone has a 'primary healthcare need' is assessed by looking at all of their care needs and relating them to four key indicators:
- nature - this describes the characteristics and type of the individual's needs and the overall effect these needs have on the individual, including the type of interventions required to manage those needs
- complexity - this is about how the individual's needs present and interact and the level of skill required to monitor the symptoms, treat the condition and/or manage the care
- intensity - this is the extent and severity of the individual's needs and the support needed to meet them, which include the need for sustained/ongoing care
- unpredictablity - this is about how hard it is to predict changes in an individual's needs that might create challenges in managing them, including the risk to the individual's health is adequate and timely care is not provided
NHS Funded Nursing Care
By law, local authorities cannot provide registered nursing care. For individuals in care homes with nursing, registered nurses are usually employed by the care home itself and, in order to fund their nursing care, the NHS makes a payment direct to the care home. This is called 'NHS Funded Nursing Care' and is a standard rate contribution towards the cost of providing registered nursing care to those individuals who are eligible.
Registered nursing care can involve many different aspects of care. It can include direct nursing tasks as well as the planning, supervision and monitoring of nursing and healthcare tasks to meet your needs.
Who is eligible for NHS Funded Nursing Care?
You should receive NHS funded nursing care if:
- you are resident within a care home that is registered to provide nursing care; and
- you do not qualify for NHS continuing healthcare but have been assessed as requiring the services of a registered nurse.
In all cases individuals should be considered for eligibility for NHS continuing healthcare before a decision is reached about the need for NHS funded nursing care. Consequently most individuals will not need to have a separate assessment for NHS funded nursing care if they have already had a full multidisciplinary assessment for NHS continuing health care, as this process will give sufficient information to judge the need for NHS funded nursing care. However, if an assessment is needed, please see below for how to request one.
If you are not happy with the decision regarding NHS funded nursing care, you can ask for the decision to be reviewed and/or use our Complaints Procedure.
How to request an assessment
If you think that you or a member of your family may be eligible for an assessment, you can request a professional involved in the person’s care to complete the first stage of the assessment, which is called the Checklist. Please see the table below for a copy of the Checklist. This can be a nurse, doctor, or other qualified healthcare professional, or a social care professional, and they should have knowledge of the person and their care.
If you are being discharged from hospital, the Discharge Planning Team can complete a Checklist when you are medically fit to be discharged. If you are leaving a period of rehabilitation such as an Intermediate Care placement, you may also be assessed using the Checklist when you are medically fit to go home.
If a person is suffering from a terminal illness and entering the final stage of their illness, then they can be assessed using a Fast-Track Assessment Tool. Please see the table below for a copy of the Fast-Track Assessment Tool. This can only be completed by a medical professional who has knowledge of the person and their care.
If you are a healthcare professional and have been asked for a CHC Checklist or Fast-Track assessment, please see our Continuing Health Care guidance for practice colleagues
What happens next?
If the checklist process indicates that it is appropriate, a full Continuing Health Care assessment is made, using the Decision Support Tool, by a multidisciplinary team of professionals. Please see the table below for a copy of the Decision Support Tool.
Where else can I get information?
- Brighton & Hove City Council Social Care can assist with a person’s social care needs such as assistance with day-to-day tasks
- The Department of Work and Pensions lists benefits available
- Voluntary sector organisations such as The Fed and Independent Lives work to support people living with a health condition to live independently
- Patient Transport Service can support people who need help getting to hospital appointments due to a health condition.
- Age UK
- Spinal Injuries Association
- Alzheimer's Society
Freedom of Information Requests and Complaints
If you want to make a complaint, or request information under the Freedom of Information Act, please see our Contact Us page.
Continuing Healthcare Checklist
The Continuing Healthcare Checklist Document is the first stage of an assessment for Continuing Healthcare, and should be completed by a nurse, doctor, or other qualified healthcare professional, or a social care professional, who has knowledge of the person and their care.
The Checklist should be filled in by a professional currently caring for an individual. Completed checklists should be emailed as a referral to BHCCG.email@example.com
If you have any questions about this document, please contact us.
Continuing Healthcare Fast-Track Assessment Tool
The Continuing Healthcare Fast-Track Assessment Tool is used to assess a person with a terminal illness who is entering the final stage of their illness. This can only be completed by a medical professional who has knowledge of the person and their care.
If you have any questions about this document, please contact us.