Continuing Care Advice

What Is Continuing Care?

People who are old and frail, those with chronic or degenerative diseases, or perhaps with other complex health needs, may require specialist care, regular treatment or other support on a long-term basis. For adults - this is known as NHS Continuing Healthcare (CHC), a package of care and support offered by the NHS - working with a range of different agencies - to meet a patient's assessed needs, whether they are physical, mental or involve personal care.

Continuing Care enables people to regain their independence following a stay in hospital or in response to an illness, accident or disability, giving them the support they need to maintain or improve their quality of life.

NHS Continuing Healthcare is provided free of charge for people aged 18 or over who are are assessed as being eligible. It can be arranged in a variety of settings, including your own home, a hospital, hospice or care home.

If someone in a care home gets NHS Continuing Healthcare, it will cover their care home fees, including the cost of accommodation, personal care and healthcare costs. If NHS Continuing Healthcare is provided in the home of the person you look after, it will cover personal care and healthcare costs. It may also include support for you as a carer.

Continuing Healthcare may be offered for prolonged periods but not necessarily for life, so a patient's entitlement will be reviewed at regular intervals.

Children and young people under 18 may be eligible for a similar type of provisions , called Children and Young Peples Continuing Care. This is organised differently, under its wn national framework. See the Children and Young People's Continuing Care national framework at www.gov.uk.

A revised version of the National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care was published by the Department of Health in May 2022 and implemented on the 1st of July 2022.

The Framework sets out the criteria used to assess if you're eligible for continuing care or NHS-funded Nursing Care, as well as the procedure for investigating cases where people may have been wrongly denied continuing care. National tools are in place, including a Checklist, Decision Support Tool and Fast Tracking Tool, to help define who is eligible for NHS Continuing Healthcare. Under the Framework, there is also a single national rate of payment for NHS-funded Nursing Care in a nursing home, meaning the NHS provides the same contribution to everyone receiving this type of care.

Who is eligible for NHS Continuing Healthcare?

You must be over 18 and have a complex medical condition and substantial and ongoing care needs. NHS Continuing Healthcare is designed to support people whoes primary need is a 'health' rather than 'social' care need and, as such, have conditions that stay with them after they leave hospital.

NHS Continuing Healthcare is usually for people with long-term illnesses, disabilities, or complex conditions that are unlikely to improve quickly. It is not normally provided for shortterm or temporary needs, such as recovery from a routine operation.

NHS Continuing Healthcare is free of charge to people who are assessed as eligible. The NHS covers the cost of the care package in full, whether provided in your own home, a care home, hospice, or other setting. People may still choose to pay for additional non-essential services (such as higher accommodation standards), but the care itself is NHS-funded.

In England, local authorities can charge for other types of communitybased social care services (such as home help or respite care) if they are not covered by NHS Continuing Healthcare.

You can read more about NHS Continuing Healthcare on the NHS website at www.nhs.uk.

Who decides about NHS Continuing Healthcare?

Prior to your discharge from hospital, the decision about whether you qualify for NHS Continuing Healthcare is taken by a multi-disciplinary team of healthcare professionals. Among these may be your GP, nursing staff, physiotherapists and members of the social services.

This team will discuss with you and your family how any eligibility decisions have been reached as well as how, when and where the NHS Continuing Healthcare is to be provided. In the first instance, the hospital will explain the procedure for discharge and for ongoing healthcare thereafter.

If you need both health and social care, a joint package of care may be arranged, with responsibilities shared between the NHS and the local authority. Staff should explain which aspects of your care will be NHSfunded and which may be subject to means-tested social care charges.

A decision about eligibility should usually be made within 28 days of an assessment being carried out.

Patients have the right to ask for a review of any decision made by the team - especially about discharge from hospital. All hospitals and Integrated Care Boards also have a Patient Advice and Liaison Service (PALS) to help sort out problems or give you advice.

While you are in Hospital

The prospect of a stay in hospital can be daunting if you are not used to it. To help allay any fears that you may have, it is wise to make sure that you understand your illness.

They say knowledge is power and, in these terms, a better understanding of your condition will help you feel more in control and less anxious.

When in doubt, ask questions and you will find that your consultant, doctor or nurse will take the trouble to explain the reasons for their diagnosis. Likewise, be sure you understand why you are receiving certain medication or what undergoing a particular treatment will entail.

Discharge from Hospital

Where it has been assessed that you do not require ongoing NHS Continuing Healthcare you do not have the right to occupy an NHS hospital bed indefinitely. However, you do have the right to request a review of decisions made about your discharge from hospital and you cannot be discharged into a care home against your will.

If you do have concerns about being discharged from hospital and your right to Continuing Healthcare, you may wish to seek support and advice from the Patient Advice and Liaison Service (PALS) – ask a member of staff in the hospital for details of the local PALS office; there should be one in the hospital itself.

Discharge to a Care Home

Where you have been assessed as needing care in a care home – either arranged by your local authority or privately – you can choose the home you wish to go to, subject to it being suitable and affordable with the funding arrangements.

In England all care homes are registered and regulated by the Care Quality Commissions (CQC). Different care standards authorities apply in Wales and Scotland.

Ongoing Support for Mental Health and Learning Disabilities

In England, approximately 1.5 million people are defined as having learning disabilities including 950,000 adults aged 18 and over.

As many as one in four of us are likely to experience mental health issues, such as depression or anxiety each year and a further one in every 100 experience severe mental illness, which may include a temporary period where they lose touch with reality.

Under the framework for NHS Continuing Healthcare, your mental, emotional and psychological needs will be assessed alongside the assessment of your physical or nursing care needs before you are discharged from hospital. If you do have learning disabilities or mental health needs, a care plan should be drawn up and overseen by a care co-ordinator who will help you access support from within your local community and various services.

There are a number of agencies throughout the UK that specialise in providing home help for people with primary health needs related to mental health or learning disability. You should ask your local authority what is available in your area. As ever, the Internet is an excellent source of information.