Understanding Care Services: NHS Continuing Health Care

What Is NHS Continuing Health Care?

In England, NHS Continuing Health Care (NHSCHC) is care funded by the NHS. It is available for people aged 18 and above and is provided to meet physical or mental health care needs that have arisen through disability, accident or illness. NHSCHC is care that takes place away from a hospital. Care can be provided in your home or in residential accommodation.

Who Qualifies for NHS Continuing Health Care?

You will qualify for NHSCHC if you are assessed as having a primary health need. The NHS Choices website provides a very unhelpful circular definition of this. A primary health need, it is explained, is one that is on-going and substantial and is related to your health. An assessment will take into account the nature and complexity of your needs; the intensity and severity of your needs, and the unpredictability of your needs.

How Do You Get NHS Continuing Health Care?

In short, you need to be assessed. The assessment is carried out by a multidisciplinary NHS team. There is no right to an assessment, but if it seems that you might need NHSCHC then the Clinical Commissioning Group (CCG) for your area must carry out an assessment.

The fact that you have a long term medical condition is not, of itself, a qualification for NHSCHC. However, the following circumstances are likely to suggest that an assessment is appropriate. 1. Where  you are due to be discharged from hospital and you have long term needs, 2 Where a period of intermediate care has come to an end, 3. Where your health declines significantly, 4. Where you are approaching the end of your life, 5. Where you reside in a nursing home and your health care needs are under review and 6. Where your health and social care needs are being assessed as part of a community care assessment.

In most circumstances, there is a two stage assessment process. The first stage is an initial assessment. The purpose of this is to decide if you need a full assessment. The initial assessment may be completed by a doctor, social worker or other health care professional.

The full assessment is carried out by two or more health and/or care professionals. The assessment looks at the following criteria: behaviour, cognition (understanding), communication, psychological/emotional needs, mobility, nutrition (food and drink), continence, skin (including wounds and ulcers), breathing, symptom control through drug therapies and medication, altered states of consciousness, other significant needs.

Each of those criteria (or domains) is assessed on the following scale: no needs, low needs, moderate needs, high needs, severe needs or priority needs. The criteria in bold are assessed, on the full scale, from low through to priority. The criteria in italics are assessed from low to severe. The remainder are assessed from low through to high.

You will be eligible for NHSCHC if one or more criteria are assessed at the priority level or two or more criteria are assessed as severe. You may also be eligible if one criteria is assessed as severe and you have needs assessed in a number or other criteria or a number of criteria are assessed as high and/or moderate.

A two stage assessment is obviously a little time consuming. It can take 28 days from the initial assessment to determine you eligibility by way of a full assessment. Clearly in some cases this is far too slow. There is, therefore, a fast track procedure that can be used where your condition is worsening and/or you are terminally ill.

What Is the Cost of NHS Continuing Health Care?

There is no cost to you if you qualify for NHSCHC.

Who Provides NHS Continuing Health Care Services?

NHSCHC services can be provided by any number of health professionals including physiotherapists, occupational therapists, speech therapists and domiciliary carers. When you are assessed as being eligible for NHSCHC, you will be allocated a personal health budget. This is an amount of money that is used to support the needs that you have. It is similar to the personal budgets allocated by social services to support social care needs.

Just as with a social care personal budget, you can ask for your personal health budget to be paid to you in the form of a direct payment. A direct payment puts you in control of choosing who supplies your services. You don’t have to do this. You may, however, enjoy the freedom and choice that direct payments give you. You can find out more about personal health budgets and direct payments on this page.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.

Will You Support John’s Campaign?

What Is John’s Campaign?

I want to tell you about a campaign; it’s a very special campaign; you may have heard of it; you may not; it’s called John’s Campaign. If you’ve heard of it you’ll know how important it is; if you haven’t heard of it, let me tell you why it’s important; it’s important because it deals with an issue that will touch the lives of many of us at some point: John’s Campaign is the campaign for the right to stay with people with dementia in hospital.

The campaign was named after Dr John Gerrard who died five weeks after entering hospital in November 2014. John was aged 86 when he died. He had been diagnosed with Alzheimer’s disease when he was in his mid-70s. He went into hospital to have treatment for leg ulcers. His family described his decline as catastrophic.

Going into hospital is unnerving and unsettling for most of us. For someone with dementia who is already confused, insecure and frightened the experience is something that we can only try to imagine. How can any society with any claims to being a compassionate one deny people with dementia the comfort of having a familiar figure with them when they are in hospital? One of the most important elements of support that people with dementia can be given is the reassurance that comes from having trusted people with them.

June Andrews, Professor of dementia studies at the University of Stirling puts things starkly: “…for many [people with dementia], getting admitted [to hospital] is the top of a slippery slope.” To find out what things might be encountered once on the slippery slope I recommend Andrews’ article to you. Further information is provided as follows by the Alzheimer’s Society:

• Over a quarter of hospital beds in the UK are currently occupied by people with dementia
• The average stay of a person with dementia is three weeks but it can be much longer if rehabilitation is a problem or there is nowhere suitable to go
• One third of people with dementia who go into hospital for an unrelated condition NEVER return to their own homes
• 47% of people with dementia who go into hospital are physically less well when they leave than when they went in
• 54% of people with dementia who go into hospital are mentally less well when they leave than when they went in

As things stand, there is no general right for carers, family or friends to stay with people with dementia when they are in hospital. Practice varies from hospital to hospital and from ward to ward. By supporting John’s Campaign you will be supporting the right to stay with people with dementia in hospital.

What Can You Do?

1.      Go to the website of John’s Campaign, in particular this page, which explains different things you can do.

2.      Download, read and disseminate widely the John’s Campaign Statement.

3.      This is an election year. You can question candidates about how they and their parties stand on the issue.

4.      Write to your local NHS trust and ask what its policy is.

5.      Go to the John’s Campaign Facebook page, like it and encourage all your friends to do the same.

It strikes us as almost unbelievable today that there was once a time - and it was a time in the not too distant past - that parents were not allowed to stay with their sick children in hospital. The generation who won the right for parents to stay with their children when they are in hospital is the generation who will benefit when John’s campaign succeeds.

If you have read this far, please support John’s Campaign.

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.