What is NHS CHC? Continuing Health Care (CHC) is care provided by the NHS. The NHS pays for the total cost of a person’s care and the service is not means-tested (i.e. the person’s financial circumstances do not have any bearing on their eligibility for funding). The NHS pays the person’s care fees direct to the care provider. What is the process for obtaining CHC? A person must have a “primary health need” to be eligible. An assessment of whether a person has a primary health need will be carried out by using a checklist. The checklist is a screening tool and is used to identify whether a full assessment of a person’s needs should be carried out. The checklist involves scoring 11 care domains from A-C based on the level of the person’s needs in each area. The domains are breathing, nutrition, continence, skin (including tissue viability), mobility, communication, psychological & emotional needs, cognition, behaviour, drug therapies and medication: symptom control, and altered states of consciousness. A person will either be found to be ineligible for CHC at this stage, or they will be referred to the next step in the assessment process (the decision support tool – DST) if there is a possibility that they may be eligible for funding. The DST involves scoring 12 care domains (the same 11 domains as the checklist but with an additional domain of other significant needs) with one of 6 levels of needs – no need, low, moderate, high, severe or priority. As with the checklist, the outcome of the DST will determine whether a person is eligible for CHC. Can the CHC process be fast tracked? The assessment process may be bypassed if a person has a) a rapidly deteriorating condition and b) they have a clear need for end-of-life care. What if I am not eligible for CHC? If you are not eligible for full NHSCHC funding, if you require care from a registered nurse, the NHS may cover the cost of this element of your care. A person would be expected to be in a nursing home (as opposed to a care home) to qualify and if eligible, the NHS will pay the contribution direct to the care provider. Can I appeal a decision? You can. As a first step, you should request a copy of the DST to review the decision. If you disagree with the decision made, you can request a “local review”. The local review can be further challenged via escalation to NHS England and (depending on the circumstances) through judicial review of the decision. What if I am acting as a deputy? A deputy for property and affairs must seek specific authority to conduct litigation on behalf of the protected party before challenging an eligibility decision. Failure to do so will mean that the deputy’s costs are at risk. How can Morr & Co help? Morr & Co can assist with general advice about eligibility for health care funding. We can also provide advice as to prospects of success in appealing a negative DST assessment and can act on your behalf in an appeal. If you intend to appeal a decision, there are strict deadlines at some parts of the appeals process and so you should seek advice in a timely manner. If you have any questions or would like any further information on the content of this article, please do not hesitate to contact Alice Watkins, or an alternative member of our Court of Protection team on 0333 038 9100 or email info@morrlaw.com and a member of our expert team will get back to you. Disclaimer Although correct at the time of publication, the contents of this newsletter/blog are intended for general information purposes only and shall not be deemed to be, or constitute, legal advice. We cannot accept responsibility for any loss as a result of acts or omissions taken in respect of this article. Please contact us for the latest legal position. Authored by Alice Watkins Associate Solicitor Message Tags Insights On this page Related Stories Social care journey Care Fees – Top ups View more Contact our team today to find out more Contact us
