In NHS Continuing Healthcare, do care needs have to be unpredictable?
No. 16 in our series of 27 top tips on NHS Continuing Healthcare…
This week we read yet another misleading press article about NHS Continuing Healthcare.
The article was talking about care fees and (to its credit) it did actually mention NHS Continuing Healthcare. However, it then went on to define what kind of care needs count in NHS Continuing Healthcare assessments.
It stated that needs have to be unpredictable for someone to qualify for full funding.
This is the kind of incorrect and misinformed statement that does so much damage. Sadly it happens over and over – families being given misleading information in news articles, or by people inside and outside the care system who misinform and misdirect (whether knowingly or not).
So what kind of care needs count in NHS Continuing Healthcare?
3 points to help you:
1. Read the Decision Support Tool; page 15 talks about the scores needed across the various care domains:
“A clear recommendation of eligibility to NHS continuing healthcare would be expected in each of the following cases:
~ A level of priority needs in any one of the four domains that carry this level.
~ A total of two or more incidences of identified severe needs across all care domains.…”
Don’t let anyone convince you these scores don’t count.
2. Read about the four ‘characteristics’ of need on page 47 of the Decision Support Tool:
“Reaching a recommendation on whether the individual’s primary needs are health needs should include consideration of: Nature… Intensity… Complexity… Unpredictability… Each of these characteristics MAY, in combination OR ALONE… [i.e. only one of them]… demonstrate a primary health need…”
Nowhere does it say that needs have to be unpredictable.
Nowhere does it say that these four characteristics (Nature, Intensity, Complexity and Unpredictability) override the scores in the care domains.
3. Keep in mind the local authority legal limit – a level of care beyond which the NHS must – by law – cover the full cost.
So let’s be clear:
Care needs do NOT have to be unpredictable to secure NHS Continuing Healthcare funding – and an NHS Continuing Healthcare assessment should take account of the whole picture of need.
So when you’re looking at what kind of care needs count in NHS Continuing Healthcare, remember the points above.
You don’t have to fight this battle alone
Fighting a Continuing Healthcare funding battle alone can feel daunting. If you need to talk to someone about your case, read more here.