The Continuing Health Care assessment uses a Decision Support Tool to determine an individual’s health needs in order to determine is they qualify for funding. This assessment takes a wide range of health needs into consideration by focusing on 12 highly specific domains, including cognition, behaviour, nutrition, and mobility.
The Decision Support Tool assessment assigns a level of need to each of the 12 domains, where 6 levels range from ‘no needs’ to ‘priority’.
Understanding the continuing health care assessment
The Continuing Healthcare assessment process can be fraught with complications, often delaying funding for individuals as a result. This is why many people work with a solicitor to determine how much funding they are eligible for, recover unpaid fees, or challenge the NHS’s decision if they believe the funding has not been correctly awarded, is too low or unfair.
While some people do prefer to do it on their own when it comes to an assessment for NHS Continuing Healthcare (CHC), it is strongly recommended that you seek the advice of a solicitor specialising in CHC funding. The eligibility criteria can be difficult to meet, as is being able to demonstrate that your needs indeed qualify for funding.
What is a CHC assessment?
The NHS Continuing Care assessment or simply CHC assessment is a detailed evaluation of an individual’s care needs, so that their eligibility for funding can be determined. This assessment incorporates a form known as the DST or Decision Support Tool.
In case you’re not familiar with what the NHS’s CHC is, it is a care package aimed at providing funding for individuals who have a primary health need due to an illness, accident, or disability.
The funding is entirely arranged and paid for by the NHS, so there is no financial burden on the affected individual or his/her family. Following a CHC assessment, funding can be provided in multiple settings, although the most common one is either at the individual’s private residence or in their current care/nursing home.
The assessment for NHS Continuing Healthcare includes a checklist which considers 12 specific areas of care:
- Altered state of consciousness
- Behaviour
- Breathing
- Cognition
- Communication
- Continence
- Drug therapies & medication
- Mobility
- Nutrition
- Psychological & emotional needs
- Skin
- Other significant care needs for consideration
The checklist works along a scoring system, assigning an ‘A’, ‘B’, or ‘C’ score to each area. ‘A’ indicates the highest level of care needs, while ‘B’ indicates a moderate level, and ‘C’ indicates a low level or no needs at all.
With the above in mind, individuals with young onset dementia or rarer conditions might find it challenging to prove their eligibility for CHC. By seeking the professional guidance of a solicitor, you can ensure that you get the appropriate score during the CHC funding assessment as per your health needs.
Full assessment for NHS continuing healthcare explained
The full assessment for NHS Continuing Healthcare is undertaken by a multidisciplinary team (MDT) made up of at least two professionals from different backgrounds. Therefore, the MDT should be a mix of social and health care professionals who are, at present, involved in administering care to the affected individual.
The detailed evaluations help determine whether you are eligible for CHC funding. The MDT will rely on the DST (Decision Support Tool) to assess your health needs under the 12 respective domains. They will consider the complexity, intensity, nature, and unpredictability of your needs under these areas or domains.
It’s important to understand that the full assessment for NHS Continuing Healthcare is only triggered once you pass a screening stage through the CHC checklist, where the scoring threshold is set low in order to help people get screened as easily as possible.
A decision of your eligibility is given within 28 days if you have a positive checklist result – that is, you have qualified for the next stage in order to have your eligibility established.
What is fast track assessment for NHS continuing healthcare?
The fast track assessment for NHS Continuing Healthcare is a process where individuals with rapidly deteriorating health conditions or those who are approaching ‘end of life’ can be screened, so that they can receive the required funding.
In order to be eligible, you must have a rapidly deteriorating health condition which is either in the terminal phase or about to enter it.
A healthcare professional, such as a general physician (GP), registered nurse, registrar, or health consultant, will complete the assessment for you via a Fast Track Pathway Tool. This tool is used to record your health condition, including diagnosis, prognosis, current and future health needs, and details of the condition deteriorating.
Your local ICB (Integrated Care Board) should then accept and process the request without delay, but only if the designated healthcare professional recommends fast-tracking. Once the assessment is accepted, the NHS (as per their claim) should have a care package in place within two days.
A noteworthy fact is that a successful fast track assessment for NHS Continuing Healthcare allows access to NHS funding without any delay whatsoever, hence, helping individuals meet the cost of care towards the end of life stage. Furthermore, the fast track pathway bypasses the regular NHS CHC assessment criteria, not requiring the completion of a DST (Decision Support Tool).
CHC assessment process
Let’s recap some of the steps from above in regards to the CHC assessment process, in addition to the information below:
- Checklist – A GP, nurse, social worker, or healthcare professional will complete the initial checklist assessment for you. This checklist helps to determine whether you are eligible for a full assessment.
- MDT – A multidisciplinary team is appointed to collect evidence and assess your needs. During this phase, the MDT may contact you directly as well to acquire the necessary information.
- DST – The MDT completes the Decision Support Tool to offer a recommendation on your eligibility.
- ICB – If you are eligible, the (Integrated Care Board) will arrange a care package.
While the assessment process ought to be individual-centred and fair, it just so happens that, sometimes, the affected person may not be at the centre of the process, and there may be discrimination based on race, age, gender, or disability, or otherwise.
Working with a solicitor ensures that you are always at the centre of the process, your needs are accurately assessed, and that you get the full funding support in the shortest timeframe possible.
