And, All and Full – 3 powerful words to help you in NHS Continuing Healthcare
We’ve mentioned in other articles just how important it is to read the NHS Continuing Healthcare guidelines before you go through the Continuing Healthcare assessment process and when you’re appealing a funding decision.
It’s easy to miss certain words that can actually help you a lot when arguing your case. We’ve highlighted 3 of those words for you here.
They relate to the Decision Support Tool – the form that assessors complete (with your input) during the full multidisciplinary team (MDT) assessment. (The MDT is stage two of the process.)
3 points from NHS Continuing Healthcare guidance
1) Decision Support Tool, page 9, paragraph 7:
“Once an individual has been referred for a full assessment for NHS continuing healthcare (by use of the Checklist or, if this is not used in an individual case, by direct referral for a full assessment for NHS continuing healthcare) then, irrespective of the individual’s setting, the CCG has responsibility for coordinating the whole process until the decision about funding has been made AND a care plan has been agreed.”
In other words, part of the purpose of the Continuing Healthcare assessment is to ascertain what the whole picture of care needs looks like – what is needed and how that can be put in place. The NHS has a duty to ensure that your relative has the correct care – not just the correct funding – and of course the funding must cover all the assessed care needs.
2) Decision Support Tool Glossary, Page 50, last paragraph – regarding NHS Continuing Healthcare at home:
“…where a person lives in their own home, it means that the NHS funds ALL the care that is required to meet their assessed health and social care needs.”
We’ve written before about receiving NHS Continuing Healthcare funding at home, and the NHS’s own guidance makes it very clear that the funding must cover all care needs, regardless of where a person actually receives their care.
3) Decision Support Tool Glossary, page 50, last paragraph – regarding NHS Continuing Healthcare in a care home:
“In care homes, it means that the NHS also makes a contract with the care home and pays the FULL fees for the person’s accommodation, board and care.”
We’re increasingly hearing accounts from families that Continuing Healthcare funding is being ‘capped’, i.e. families are being told that the NHS will only pay a certain amount towards care, but not all of the care fees. As clearly shown in Continuing Healthcare guidelines. this is just plain wrong.
In addition, no one should be asked to ‘top up’ Continuing Healthcare – and the care home shouldn’t ask you either! The NHS has a legal duty to cover all the costs, and the contract for the funding is between the NHS and the care home. The fact that a person is in receipt of NHS Continuing Healthcare means that their care is beyond the limits of local authority care – and tops ups are for local authority care only.