Continuing healthcare

The English national framework for NHS continuing healthcare came into force on 1 October 2007. People who qualify are entitled to care paid for by the NHS, for which they do not have to pay, rather than social care which is means-tested. Most of those who qualify need Nursing home care. It is in the interests of local Social Services Departments to establish entitlement to continuing healthcare as this relieves them of any financial responsibility.

Payments until 2013 were administered by Primary Care Trusts and this was transferred to Clinical Commissioning Groups. Many CCGs found towards the end of 2014 that they were in financial difficulties facing the combination of an ageing population with complex health needs and increasingly expensive care packages.^[1]

In order to qualify a comprehensive assessment of the person's care needs must be carried out by a multidisciplinary team, including relevant specialist and non-specialist assessments. An eligible person must establish that they have complex medical condition and substantial and ongoing care needs.^[2] The framework replaced PCT's individual policies for assessing eligibility for continuing care and local care planning and review processes with the intention that the same criteria would be used throughout England. Funding already in place may be withdrawn following a joint reassessment of health and social care needs.^[3]

In October 2014 the Northern, Eastern and Western Devon Clinical Commissioning Group found they were seeing an average of 34 CHC claims each month and planned to save up to £4.5 million by reviewing the decision making thresholds for these claims. It also aimed to bring the prices paid into line with other areas and possibly bring assessment of claims which are currently carried out by community providers back in house.^[4]

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