What Happens After Continuing Healthcare Checklist?

In our previous blog here, we discussed what the first step should be for obtaining the National Health Service (NHS) Continuing Healthcare (CHC). If the person passes the CHC Checklist, a full assessment should be carried out. This is a multi-disciplinary team (MDT) assessment involving professionals from at least two disciplines, ideally a nurse and a social worker.

What a CHC full assessment involves?

The MDT complete a document called the Decision Support Tool to examine the:-

• 12 health and care domains; and
• 4 characteristics under the primary health need test, i.e. nature, intensity, complexity and unpredictability.

It is very common that the MDT have little or even no knowledge of the person being assessed. They will therefore contact the person being assessed (depending on his/her capacity) and/or the persons who care for the person being assessed (such as relatives) to get more information about the person’s health and social care needs. They will also consider the care and medical records of the person being assessed.

Once all of the relevant evidence has been gathered in the above domains, the MDT will assign a level of need (i.e. no needs, low, moderate, high, severe and priority) to each domain. The level of need is not the determining factor for CHC but a guide. The MDT will then analyse the above characteristics that determine eligibility for CHC.

The MDT may also have meetings with professionals from different specialisms (such as consultants, clinical nurse specialists, social workers, physiotherapists and psychologists) to develop a treatment plan for the person.

The MDT will then make eligibility recommendations to the Integrated Care Board (ICB) based on the nature, complexity, intensity and unpredictability of needs.

What happens after the MDT make eligibility recommendations?

The MDT submits their recommendations to the ICB for ratification. The ICB does not generally overturn the MDT’s recommendations unless there is a clear rationale and evidence.

If the individual is eligible for CHC, the ICB/NHS become responsible for arranging and funding all of the health and social care needs, including nursing and personal care, in any setting. The NHS must make arrangements without unnecessary delay.

Attending a meeting with the MDT can be a stressful experience and having an advocate with you can ensure that the health and social care needs of the person being assessed are adequately represented. Contact a member of our Team so we can guide you through this process.