NHS continuing healthcare
NHS continuing healthcare is the name given to a package of care that is commissioned and funded solely by the NHS. It is not means-tested and if an individual is found eligible under the national eligibility criteria, they can receive their package of care in any setting outside of hospital.
To assist in deciding whether the NHS should provide a care package under NHS continuing healthcare after someone is discharged from hospital the individual must be assessed as having a “primary health need”.
Primary health need
The “primary health need” test is composed of four criteria regarding the characteristics of need and their impact on the care required to manage those needs. To help understand the 'quality' or 'quantity' of care required and whether it is more than the limits of a local authority’s responsibility to provide care, the primary health need test considers: nature, intensity, complexity and unpredictability of the care needs.
There has been a national framework for determining eligibility since 2007, along with national tools and eligibility criteria to help assess eligibility. Eligibility is not based on diagnosis. It is based on the care needs arising out of a particular condition(s) and a person has to be assessed to determine eligibility.
Eligibility assessment
In a hospital setting someone should only be assessed for eligibility once their acute care and treatment has reached the stage where their needs on discharge are clear.
It should always been borne in mind that assessment of eligibility that takes place in an acute hospital may not always reflect an individual’s capacity to maximise their potential. This could be because it is difficult to make an accurate assessment of an individual’s needs while they are in an acute services environment.
In order to address this issue and ensure that unnecessary stays on acute wards are avoided, there should be consideration of whether the provision of further NHS-funded services is appropriate; this might include therapy and/or rehabilitation. Where NHS-funded care, other than on an acute ward, is the next appropriate step after hospital treatment, this does not trigger the responsibilities under the Community Care (Delayed Discharges etc.) Act 2003.
NHS Continuing healthcare survey
To be better understand the experiences of those managing the application of national framework for NHS continuing care, NHS Improvement – Stroke designed a survey which was distributed nationally through its SIP e-bulletin and contacts in social care and NHS trusts.
View a presentation on the results of the survey
The findings of the survey were used to inform the nature and content of a national workshop on continuing healthcare (CHC).
NHS Continuing Healthcare Workshop
NHS Improvement – Stroke held a workshop on managing the CHC process on 6 December 2011 in London. Delegates from NHS trusts and local authorities heard presentations on practice issues relating to the management of the CHC process, changes made locally to improve patient and carer experience of being assessed for eligibility, examples of good practice, and the results of the national CHC survey.
The afternoon programme contained two sessions:
- the issues affecting the smooth and efficient operation of a CHC process, particularly in relation to hospital discharges
- possible solutions to the issues identified
A key output of the workshop was the development by delegates of a Guide for Improving the Management of the CHC Process.
View the presentations from the CHC Workshop.
Resources
A selection of NHS continuing healthcare resources including the national framework, practice guidance, tools, leaflets and case studies can be viewed on our resources page.