NHS continuing healthcare
Some people with long-term, complex health needs qualify for care that's arranged and paid for entirely by the NHS. This is NHS continuing healthcare. It can be provided at home or in a care home, and it isn't means-tested.
Who qualifies
It depends on the person's needs, not on a particular illness or diagnosis. The assessment looks at what help they need, and how complex, intense and unpredictable those needs are, including the risks if care isn't given at the right time.
How the assessment works (England)
The NHS must assess someone if it seems they may need continuing healthcare. You can ask the GP, the hospital or the council.
- First comes a short checklist, which a nurse, doctor, other health professional or social worker can complete. You should be told it's happening and given a copy.
- If the checklist suggests they might qualify, a team of at least 2 professionals does a full assessment, looking at needs such as breathing, eating and drinking, continence, skin, mobility, communication, understanding, behaviour, medicines and psychological needs.
- A decision about a full assessment should usually be made within 28 days.
- If someone is terminally ill and needs care urgently, the assessment can be fast-tracked.
Families should be fully involved and consulted. Take notes, and ask for copies of everything.
If they don't qualify
The NHS may still pay for part of the care alongside the council, sometimes called a joint package. Someone in a nursing home who needs care from a registered nurse may get NHS-funded nursing care towards the fees. The council can also assess for help with social care costs. See paying for care.
You can ask for a decision to be reviewed. Beacon, an organisation that gives free independent advice on NHS continuing healthcare, can help: beaconchc.co.uk.
In Wales
Continuing NHS Healthcare works in a similar way, based on the nature, intensity, complexity and unpredictability of someone's needs. There's a fast-track process for people approaching the end of life, and you can ask for a review or appeal through NHS Wales procedures.
In Scotland
NHS continuing healthcare was replaced in 2015 by Hospital Based Complex Clinical Care. It's based on one question: can the person's care needs be properly met anywhere other than a hospital? If they can, care is arranged in the community, such as at home or in a care home, with the NHS still meeting medical needs.