There are many myths and misconceptions about NHS Continuing Healthcare, and many families find the process confusing because of the misinformation they’ve been given.
Here are some tips to help with some of the questions families ask most – addressing some of the typical mistakes in NHS Continuing Healthcare assessments:
- No one can say whether a person will or won’t be eligible for Continuing Healthcare funding until the assessment process has been carried out and a full picture of need has been established – including risk.
- Many people are told that to qualify for NHS Continuing Healthcare you have to have a PEG feeding tube. Or you have to be at the end of life. Or be completely immobile. Or be unable to swallow. Or be in a coma… or have some other specific problem. None of these are true. They may contribute to the full picture of need, but don’t be put off if your relative doesn’t display these specific things. Eligibility is about the whole picture of care needs and risks – and it’s not about any specific diagnosis or any one specific problem.
- The qualifications of the person delivering the care are irrelevant. This is a vital point. What matters are the nature of the care needs, not who delivers the care. It can be a husband or a wife, a carer or someone else – it does not have to be a nurse.
- You do not have to be in a nursing home to qualify for NHS Continuing Healthcare. You can be in any kind of care home, or you can be in your own home, or somewhere else. The care setting (i.e. where the care is delivered) is irrelevant.
- There are two main stages of the Continuing Healthcare assessment process: 1) The Checklist; and 2) A full assessment by a multidisciplinary team (MDT) where a Decision Support Tool (form) is completed with input and evidence from all relevant health and social care professionals, and with input and involvement from the family. Note: The Checklist does not determine eligibility; instead, it is a screening process and determines whether you go through to stage 2, the full assessment.
- A separate Fast Track process is available for people in a period of rapid deterioration or at end of life. It’s important to remember that a period of rapid deterioration does not necessarily have to be at the end of life stage. Many people are wrongly told that the Fast Track is for end of life care only. This is not true.
- One of the most important factors in determining whether a person is eligible for NHS Continuing Healthcare (and this is often ignored) is whether their care needs are beyond those for which a local authority can legally take responsibility. This was reinforced in the Coughlan case at the Court of Appeal. If the care needs are beyond the scope of a local authority, they are by default the responsibility of the NHS to fund. This is why it’s vital that a social worker or other representative from the local authority attends a full assessment MDT meeting. If a person is found not eligible for NHS Continuing Healthcare and yet their needs are indeed beyond the local authority’s remit, the local authority will be acting illegally in taking responsibility/means testing.