Eligibility For Continuing Healthcare UK

By June 30, 2018Continuing Healthcare
This post was originally published on this site

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Continuing Healthcare is a package for individuals who have been found to a have a Primary Health Need to receive ongoing care at home, in a care facility such as a nursing home or in a hospital. Each case is assessed individually in order to establish whether a person is eligible to receive NHS Continuing Healthcare.

This assessment is used to determine the need for care resulting from an illness, injury or disability rather than the diagnosis of an illness, injury or disability. Assessments are conducted by Clinical Commissioning Groups who take a multidisciplinary approach to evaluating the type of need for care, how complex the need is and how serious the needs is.

The assessment may be conducted before or in conjunction with a means test. This test is to establish the financial means of an individual, family or other social care package to cover the cost of the required care. However, the means test is not used to determine eligibility for NHS Continuing Healthcare.

The means test is conducted by a local authority and may result in an individual not applying to be assessed for an NHS package for which they may have been eligible. Even if a means test has been taken and a decision made that the healthcare needs can be taken care of by the family or individual with needs, it is still important to be assessed.

Family members, caregivers and the individual in need of care are all taken into consideration in conducting the assessment and determining the need for care. The assessment is a process and eligibility is normally determined within 4 weeks of the start of assessing individual needs.

The process begins with an initial assessment checklist to evaluate whether an individual meets the necessary requirements to undergo a full assessment. The checklist must be completed by a qualified medical professional such as nurse, medical doctor or social worker.

The medical professional completing the checklist will either recommend an individual for a full assessment or deem them to not be eligible. Reasons for the decision must be stated in writing on the checklist. Persons who do not meet the requirements will not be assessed by a CCG group and will be directed to a local authority to determine eligibility for other types of support.

If a full assessment is recommended, a CCG multidisciplinary team will be formed consisting of a minimum of 2 medical healthcare professionals who are involved with the care of the individual in question at the time. Needs will be assessed according to the following categories:

  • Behavioural
  • Cognitive
  • Communication
  • Mental, emotional or psychological
  • Mobility
  • Diet and nutrition
  • Continence
  • Skin
  • Breathing
  • Treatments, drugs and medications
  • Consciousness
  • Any other contributing factors

Each category will be rated according to the following level of need:

  • No needs
  • Low
  • Moderate
  • High
  • Severe
  • Priority

One priority need or two severe needs should qualify an individual for NHS Continuing Healthcare. High and moderate needs in multiple categories may also result in a support package being provided.

Support packages are reviewed every 3 months and may be adjusted as the needs of an individual change.