For many families across the UK, the prospect of funding long-term care for a loved one can be daunting, with costs often running into thousands of pounds each month. However, a significant source of support exists in the form of NHS Continuing Healthcare (CHC), a package of care funded entirely by the NHS for individuals who have a 'primary health need'. James Urquhart-Burton, head of continuing healthcare claims at Winston Solicitors, recently shed light on the application process, offering invaluable guidance for those seeking to secure this crucial funding.
NHS CHC is not means-tested, nor is it dependent on a specific diagnosis or care setting. Instead, it is awarded based on an individual's complex health needs, which are assessed against a detailed set of criteria. This means that if an individual's main care needs are health-related, rather than social care-related, the NHS is legally obligated to cover the full cost of their care, whether that care is provided at home or in a residential care facility. Understanding this distinction is the first step for anyone considering an application.
The application process typically begins with a Checklist, which is a screening tool used to determine if a full assessment for CHC is warranted. This initial stage can be conducted by a healthcare professional, such as a GP, district nurse, or social worker. If the Checklist indicates that the individual may be eligible, they will then proceed to a comprehensive multi-disciplinary assessment. This in-depth evaluation involves a team of healthcare professionals assessing various domains of need, including behaviour, cognition, communication, breathing, nutrition, continence, skin integrity, mobility, and medication management.
Urquhart-Burton emphasises the importance of thorough preparation for the multi-disciplinary assessment. Families are encouraged to gather all relevant medical records and daily care logs, and to actively participate in the assessment meeting. The key is to demonstrate that the individual's needs are complex, intense, unstable, or unpredictable, and that these needs are primarily health-related. Decisions are made by local Integrated Care Boards (ICBs) based on the evidence presented, in line with national framework guidelines. Patients and their families have the right to appeal if they disagree with the eligibility decision.
Securing NHS CHC can alleviate immense financial pressure on families, ensuring that individuals receive the necessary care without depleting their savings or selling their homes. With an ageing population and increasing demand for long-term care, awareness of entitlements like CHC is more important than ever. The NHS website and local ICBs provide detailed information and resources to assist individuals and their families throughout the application and appeals process.