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.
The process to determine eligibility is nationally defined and we follow a standard process to determine if an individual is eligible.
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.
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.
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. Download checklist_tool_april_13.pdfThis 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. Download fast_track_tool_2014.pdfThis 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. Download decision_support_tool_060315.pdf
Where else can I get information?
- Brighton and Hove City Council Social Care team can assist with a person’s social care needs, for example if they need help 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
Please follow the links to send us a complaint, comment or compliment, or to request information under the Freedom of Information Act.
The National Framework for NHS Continuing Healthcare governs how we work locally.
Personal Health Budgets
Brighton and Hove CCG is offering people eligible for NHS Continuing Healthcare their own personal health budgets to manage.
We are also exploring how personal health budgets can be made available to people with a range of long-term conditions during 2016/17.
What is a personal health budget?
A personal health budget is an amount of money that can be given directly to a person receiving certain NHS care to allow them to pay for their help and support.
The allocation of this budget is agreed between the person, their carers and their local NHS team. The budget is based upon a detailed care and support plan which identifies the health and wellbeing needs and outcomes of the individual.
Who can have one?
Since 1 October 2014 people who are eligible for NHS Continuing Healthcare (including children and young people) have had the right to have a personal health budget.
CCGs can now also offer personal health budgets to other groups of patients who could benefit from them. Brighton and Hove CCG is currently exploring how personal health budgets can be made available to people with a range of long-term conditions, people with a learning disability, and children with complex needs. During 2017/18 it is anticipated that the offer of a personal health budget will be made available to NHS funded wheelchair users.
How will it help me?
We believe everything we do should focus on people’s individual health and wellbeing needs. That’s why, wherever possible, we are trying to “personalise” the things we do.
Many people have said that by using a personal health budget, they have more flexibility, choice and control over how money gets spent on their care and support and makes them feel more involved and more positive.
A personal health budget enables you to work with a healthcare professional to prioritise the care needs that are important to you and create a care plan that reflects your own personal health and social goals. Some examples of how a personal health budget may be used include;
- Having a personal assistant to help you with your daily life, or getting out and about
- Paying a carer to live in your home to help you
- Special equipment or changes to your home that help you do everyday tasks
- Supporting you to undertake activities that help you to be part of a community, such as taking an art class or joining a gym.
How can a personal health budget be organised?
There are six basic steps to a personal health budget:
1. Get clear information
Start by talking to the NHS team who currently look after you to find out whether you would be able to access a personal health budget. If you have been referred to the Brighton and Hove NHS Funded Healthcare team, they can tell you how personal health budgets work for people eligible for Continuing Healthcare funding.
2. Understand your health and wellbeing needs
If you are able to access a personal health budget, a CCG NHS Funded Healthcare team Nurse Assessor will discuss with you how the personal health budget may work. An important part of setting a personal health budget is agreeing how the care you receive will benefit your health. This will include understanding your health and wellbeing needs. Your Nurse Assessor will talk this through with you.
3. Work out the amount of money that may be available
The CCG NHS Funded Healthcare Team Nurse Assessors can work out the amount that is available. The amount of money will be based on your health and wellbeing needs and what a conventional package of care would look like. Have a chat with your nurse if you have any concerns.
4. Make a personalised care and support plan
If you choose to have a personal health budget you will need to have a personalised Support Plan. This is developed by you and your CCG NHS Funded Healthcare Team Nurse Assessor. Together you will design a plan that meets your needs and meets NHS funding rules. You can be supported throughout this planning process by a personal health budget advisor from an independent voluntary organisation if you wish. Your Nurse Assessor can give you details of the local organisations who can help you with this.
5. Organise care and support
As soon as your Support Plan has been approved, your personal health budget will need to be activated - this can be organised in a number of different ways;
- Notional personal health budget – this means the CCG NHS Funded Healthcare team Nurse Assessor will buy the services you need directly from the service provider (e.g. a care agency)
- 3rd Party personal health budget – this means we pass on the money to someone you know, who then organises your care for you (as described in your Support Plan)
- Direct payment – this means we pass on the money directly to you, and you can organise your care (as described in your Support Plan)
You can choose one or a combination of the three options above.
Support is available to help you consider these options. If you choose to take a direct payment and therefore become an employer, you may want support with employment responsibilities (such as setting up banks accounts and payroll administration). Please see below for the contact details of some local organisations who can provide this support.
6. Make sure the money is working for you
Your Nurse Assessor is responsible for making sure the help and support you are receiving is meeting your needs. As your needs change, so might your personal health budget to make sure it is giving you the most appropriate support. Eligibility for CHC funding is also reviewed regularly.
Where can I find out more information?
If you want to know more or you have any questions about personal health budgets, you can contact the Brighton and Hove NHS Funded Continuing Healthcare Team:
The CCG has also approved a local policy that sets out the principles of how it will implement the delivery of personal health budgets across Brighton and Hove. Please visit the Plans page to read Brighton and Hove's Better Care Plan for more information.
You can also contact the following local voluntary sector organisations that specialise in providing information and support to people with personal health budgets:
- The FED
Call: 01273 296747; www.thefedonline.org.uk
- Independent Lives
Call: 08456 012399; 01903 219842; www.independentlives.org
More information is also available on the NHS England website.