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NHS CONTINUING HEALTHCARE Process Oct 2018(revised)

NHS CONTINUING HEALTHCARE Process Oct 2018(revised). What is Continuing Healthcare Funding? (CHC). CHC is a package of care for adults (age 18 and over)which is arranged solely through CHC. It can be in any setting including own home. Is not based on diagnosis or condition.

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NHS CONTINUING HEALTHCARE Process Oct 2018(revised)

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  1. NHS CONTINUING HEALTHCARE ProcessOct 2018(revised)

  2. What is Continuing Healthcare Funding? (CHC) • CHC is a package of care for adults (age 18 and over)which is arranged solely through CHC. • It can be in any setting including own home. • Is not based on diagnosis or condition. • Free at the point of delivery

  3. WHAT IS PROVIDED? • Assessed Healthcare Needs • Associated Social Care Needs • Care home fees (if applicable)

  4. The CCG – THE RESPONSIBLE COMMISSIONER • This is the responsible Care Commissioning Group in the area the person is registered with a GP. • For example if the person lives in Sevenoaks, but is registered with a GP in Bromley. • Bromley will be the responsible CCG. • Therefore the completed Checklist would be sent to the Bromley CCG.

  5. CHECKLIST: Screening Tool • 11 Domains; three levels, A,B, or C. • Minimum Data set must be completed. • Remember to complete all parts of the checklist and to sign and date. • Complete the Ethnicity monitoring as this is audited. • Rationale for Decision with all supporting evidence. • Emailed to nelcsu.chcreferrals@nhs.net

  6. When not to complete: Where it is clear there is no need for NHS Continuing Healthcare at this time Where the individual is recovering from a temporary condition and not reached their optimum potential (e.g. dialysis, rehab) or in an acute setting. The CCG has agreed the individual should be referred for a full CHC assessment and by-passing the checklist. The individual has a rapidly deteriorating condition and a Fast Track is more appropriate An individual is S117 when their health needs do not out-weigh their mental health needs. It has previously been decided that an individual is not eligible for CHC and it is clear there has been no change in needs Outlined within the checklist document on page 8.

  7. CONSENT – NHS Minimum Data Set. • Assessors should gain consent and inform the individual, that information may be shared • MCA principles should be applied if the individual lacks capacity • Person centred approach to assessment

  8. Who can complete a checklist? A variety of health & social care Practitioners, who have been trained in it’s use. Registered Nurses and MH Nurses. L.A care manager, case officer OT. Care home managers and care assistants

  9. CHECKLIST • Inform individuals and their families/ representatives that a positive checklist does not indicate eligibility for CHC • Threshold is set low. • DST will be completed if: • 1 x A in any domain carrying* (behaviour, breathing, drugs and altered states of consciousness.) • 2 or more As in any other domain. • 5 Bs or 4 Bs and 1A

  10. Checklist Domains - • Behaviour* • Cognition • Psychological Needs • Communication • Mobility • Nutrition • Continence • Skin • Breathing* • Drug Therapies & Medication* • Altered States of Consciousness* • Other significant care needs.

  11. DOMAINS • Identify appropriate level A, B, C, in each domain. • Give evidence for your scoring. • Evidence must be relevant, recent, succinct and dated. • A negative checklist should still be sent to the CCG as these are counted by NHS England and form the quarterly data.

  12. Evidence (care home, not exhaustive) • Care home records/care plans/risk assessments • Behaviour charts • Seizure charts • Waterlow scores • Weight/food/fluid charts • Medication charts • Specialist involvement/GP visits • Therapy reports • Turning charts • Falls charts

  13. We are all responsible for chc - • Get to know the limits of the Local Authority (see pg. 17 CHC Framework) and the Care Act 2014 eligibility criteria. Is my resident beginning to show signs/needs greater than social care needs? • Responsibility of person completing the checklist to provide the evidence for the domains especially if these are As or Bs.

  14. SOCIAL CARE NEEDS – CARE ACT 2014 • MANAGING & MAINTAINING NUTRITION • MAINTAINING PERSONAL HYGIENE • MANAGING TOILET NEEDS • BEING APPROPRIATELY CLOTHED • BEING ABLE TO MAKE USE OF HOME SAFELY • MAINTAINING HABITABLE HOME ENVIRONMENT • DEVELOPING & MAINTAINING FAMILY/PERSONAL RELATIONSHIPS • ACCESSING & ENGAGING IN WORK/TRAINING/EDUCATION/VOLUNTEERING • MAKING USE OF FACILITIES/SERVICES IN COMMUNITY • CARRYING OUT ANY CARING RESPONSIBILITIES ADULT HAS FOR CHILD

  15. TIMEFRAMES • CCG should take no longer than 28 days from receiving an appropriately completed checklist • To coordinate DST meeting, make a recommendation and communicate a decision. • You will receive a decision letter regarding the final decision.

  16. F.N.C Funded Nursing Care Awarded for Registered Nursing element in a nursing home NOT own home or residential home. Currently £158.16 per week. (April 2018) No update yet for 2019.

  17. *Further questions.

  18. LINKS • https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care • http://www.beaconchc.co.uk/faqs/coughlan-case-law National Framework: www.gov.uk/dh www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care MCA: https://shareweb.kent.gov.uk/Documents/adult-Social-Services/mental-capacity-act/mca-for-complex-decisions.pdf

  19. More links & resources - https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/746063/20181001_National_Framework_for_CHC_and_FNC_-_October_2018_Revised.pdf https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care https://www.ageuk.org.uk/globalassets/age-uk/documents/factsheets/fs20_nhs_continuing_healthcare_and_nhs-funded_nursing_care_fcs.pdf https://independent-age-assets.s3.eu-west-1.amazonaws.com/s3fs-public/2016-05/Factsheet-Continuing-healthcare-in-england-should-the-nhs-be-paying-for-your-care.pdf

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