NHS Continuing Healthcare

Continuing Healthcare is the name given to a complete package of care for individuals outside of hospital who have on-going care needs – the care is arranged and paid for by the NHS.  Continuing Healthcare is free and is not assessed based on your income or savings, unlike other care support from local authorities where you may need to make a financial contribution towards your care (e.g. Direct Payments).

Continuing Healthcare can be used for healthcare support, associated social care needs, and even accommodation fees if you live in residential care.  It can pay for a person’s care wherever they are living – for example, in their own home, with family carers or in residential care.

Anyone over 18 years old who has been assessed as having a certain level of care needs may be entitled to Continuing Healthcare.  It is not dependent on a particular diagnosis, but on whether you have a ‘primary health need’.

Whether someone has a ‘primary health need’ is assessed by looked at the following indicators:

  • The nature of their needs, the impact on the person and the types of care and support required.
  • The complexity of their needs and the skills required to care for them.
  • The intensity of their needs and the support required.
  • The unpredictability of changes in their needs and the responses required.

Because Continuing Healthcare is aimed at people with a high and complex level of need, few people may qualify, and even once an assessment has been requested, it can take some time to get a decision or for any funding to start.

The first step of the assessment for most individuals is the Checklist Tool.  This is a screening tool to help healthcare professionals judge whether it is suitable to carry out a full assessment for Continuing Healthcare.

The checklist does not indicate whether someone is eligible, but rather that they could be eligible and it is therefore worth doing a full assessment. The checklist screening is usually carried out during a review of support care needs or following a referral from your GP.

If a checklist is completed and it indicates that a full assessment is required, the professional who completed the checklist will contact your local Clinical Commissioning Group (CCG) who will arrange for an up-to-date support plan to be written to outline your current needs.  The plan will include contributions from all of the health and social care professionals involved in your care to build up an overall picture of your needs.  It will also include information from you about your life and how your diagnosis affects your activities.

Following the completion of the care plan, it will be reviewed by a panel and you will receive a written decision as to whether you are entitled to Continuing Healthcare, including how they reached this decision.  If you are successful, your local CCG will then get in touch with you to discuss how your care and support needs will be provided for and managed.  During these decisions, your wishes and expectations should be documented and taken into account.

If you wish to be assessed for Continuing Healthcare, you should ask your GP or Social Worker to make a referral.

For more information about Continuing Healthcare, please visit http://www.nhs.uk/chq/Pages/2392.aspx?CategoryID=68 or download the leaflet listed in the sidebar to the right.

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