Continuing Healthcare (CHC)

Anyone in Basildon and Brentwood with a primary health need may be eligible for NHS Continuing Healthcare (CHC) funded support. If not, Funded Nursing Care may be available to anyone in a Nursing Home. For greater choice over how their health and care needs are met, continuing healthcare recipients may like to consider a personal health budget.

 

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Contact us

The CCG provide this service primarily through the CHC Team based at Phoenix Court which can be contacted Monday to Friday, 9am to 5pm (excluding public holidays) by email to This email address is being protected from spambots. You need JavaScript enabled to view it. or

phone the reception and ask for the CHC team: 01268 594 350.
 
Alternatively write to us:
 
Continuing Health Care
NHS Basildon and Brentwood Clinical Commissioning Group
Phoenix Court
Christopher Martin Road
Basildon
Essex SS14 3HG
 

Booklets and documents

NHS Continuing Healthcare is the provision of care over an extended period of time to a person aged 18 years or over to meet a physical or mental health need that has arisen as the result of disability, accident or illness. NHS Continuing Healthcare means a package of continuing care arranged and funded solely by the NHS to meet a person’s health needs within the resources available.

Find out more about what NHS Continuing Healthcare and NHS funded nursing care is.
The video below was produced by NHS England and explains the framework and process for continuing healthcare [26 minutes long].

 The Q&A below provides further detail about these services and how to apply. NHS Basildon and Brentwood CCG hosts these services.

 

  • What is NHS Continuing Healthcare

    What is NHS Continuing Healthcare

    NHS Continuing Healthcare is a package of ongoing care that is arranged and funded solely by the NHS. It is designed to support individuals aged 18 or over who are found to have a primary health need which have arisen as a result of disability, accident or illness.

    The national framework for NHS continuing healthcare and NHS funded nursing care sets out the principles and processes for determining eligibility. The framework ensures that those assessing and delivering NHS continuing healthcare, do so in the same way.

    All relevant and updated documents regarding NHS continuing healthcare and NHS funded healthcare are published under the ‘useful CHC documents’ section  below.

  • What is funded NHS Nursing Care?

    What is funded NHS Nursing Care?

    If you do not qualify for NHS continuing healthcare and are resident in a care home with nursing, you may be eligible for NHS funded nursing care (FNC). This type of funding is available for people who have registered nursing needs and are receiving their care in a care home with nursing. Please note however, that being a resident in a care home with nursing does not automatically indicate eligibility for FNC.

    If you are eligible for FNC, it will be paid to the care home directly to fund your care. This means care provided, supervised, or planned by, registered nurses that are employed by the care home. If you are self-funding your care at the nursing home, these funds should be reflected in your care home fees. Please talk to the manager of the home to discuss how FNC affects your fees. If your placement is funded by social services, the FNC payment forms part of the fees paid to the care home and does not affect or change any contribution from your pension or third party top up fees.
  • What is social services currently provide my care?

    What is social services currently provide my care?

    If NHS continuing healthcare is provided at home, local social services may still have responsibilities to provide some services for you or your carers. It is possible to receive 'mixed' packages of care, where some services come from the NHS and some from social services. Where local social services provide your care, they will usually do a financial assessment to decide whether the person must make any financial contribution.

  • How do I apply for NHS Continuing Healthcare or funded nursing care?

    How do I apply for NHS Continuing Healthcare or funded nursing care?

    If you feel you may be eligible for either NHS Continuing Healthcare or NHS funded nursing care and you are registered with a GP in Basildon & Brentwood CCG, then you will need to request a CHC checklist from your local social services:

    Social Care Direct on 034560037630

     

  • How can I make a retrospective claim for care already received?

    How can I make a retrospective claim for care already received?

    A retrospective review follows a request from an individual, or their representatives, for an assessment which may look back a number of years and is the approach adopted to deal with requests for previously unassessed episodes of care. Whilst a review may involve an assessment of current needs, the review is predominantly a paper-based assessment for a period in the past. It will be undertaken by an experienced Nurse Assessor with access to patient healthcare records and nursing/residential home care notes. The review may be conducted because an individual has never been assessed, has not been assessed in recent years, or has passed away before an assessment was undertaken.

    The team can only accept requests for periods from 1 April 2012 onwards.

  • What is the retrospective review process?

    What is the retrospective review process?

    The retrospective process initially involves the collecting of information by completion of a questionnaire and consent; this will include obtaining confirmation of authority to act on behalf of the individual evidenced by production of a Power of Attorney or Grant of Probate or will detailing the executors of an estate if the individual is deceased. The CCG also required certified copies of ID to support the consent.

    Once all of this information is received, the paperwork which has been submitted will be reviewed by an experienced Nurse Assessor who will complete a screening process. This will look at the initial evidence to consider whether a full assessment for NHS CHC is necessary. We will normally write to the applicant following this initial screening to advise of the next stage in the claim process.

    If an individual is still alive, the initial screening may highlight that a current assessment of needs is required, this will be arranged, and the individual’s representative will be invited to attend. Once the outcome of any assessment is known the effect of the outcome on the retrospective request will be reviewed and the team will contact the applicant to advise the next stage.

    If on completion of the initial review, it is determined that a full assessment for NHS Continuing Healthcare is necessary, then the CCG will need to collect the relevant evidence relating to the claim period from a number of different sources. It is difficult for us to determine at this stage how long the review will take to complete as it will depend on the availability of this evidence, the length of the claim and the availability of Nurse Assessors at any given time to undertake the review itself.

    All claims that have been acknowledged will be progressed and there is no need for you to chase to ensure it is progressed. All claims are being handled in chronological order of receipt of completed paperwork as this is the only fair and equitable way to proceed. The team is happy to discuss your claim with you; we must advise that we will not be able to provide timescales for progression and completion, other than to confirm that at any specific time we have received all necessary information from you for the stage at which your claim is.

    Once all of the required evidence is held the case will be allocated to a Nurse Assessor who has the appropriate skills and is trained in continuing healthcare. Due to the number of claims received there may be a considerable delay between receipt of all required evidence and allocation to a Nurse Assessor. The assessor will scrutinise the evidence and compile a Needs Portrayal Document, pulling together all the relevant information from the different sources of evidence to build up a comprehensive picture of the individual’s needs across the whole time period. Once completed the assessor will share the Needs Portrayal Document with the applicant and request confirmation of the content and invite any comments the applicant wishes to add.

    Once completed and returned, the information will be used to apply the eligibility criteria. If a claim period spans a number of years, then the eligibility criteria may need to be applied several times. A recommendation will be made by a multi-disciplinary team (MDT) to the CCG, as to whether the patient has a primary health need during the period under review.

    If the CCG decide that the individual was eligible for all, or part of the period under consideration, the CCG will make arrangements to make a restitution payment inline with the Department of Health Redress Guidance. Basildon and Brentwood CCG calculates Redress by use of Retail Price Index.

    If the CCG decide that the individual was not eligible for CHC funding for all or part of the period being considered, the decision will be sent to the applicant with details of who to contact should the applicant disagree with the decision.

  • How do I apply for a retrospective review?

    How do I apply for a retrospective review?

    The team can only accept requests from 1 April 2012 onwards.

    If you have any queries with regard to Retrospective Reviews please contact the team:

    Email: This email address is being protected from spambots. You need JavaScript enabled to view it. or
    Phone the reception and ask for the CHC team: 01268 594 350.

    Write to us:
    Continuing Health Care
    NHS Basildon and Brentwood Clinical Commissioning GroupPhoenix Court
    Christopher Martin Road
    Basildon
    Essex SS14 3HG

  • What is a Personal Health Budget?

    What is a Personal Health Budget?

    A personal health budget is an amount of money that can be given directly to a person receiving NHS care to allow them to purchase care that is tailored to their individual needs. The allocation of this budget is agreed between the individual and their continuing healthcare team, based upon a detailed care and support plan which identifies both healthcare and wellbeing outcomes.

    We believe everything we do should focus on people’s individual health and wellbeing needs. That’s why wherever possible we are trying to personalise the things we do.

    Many people have said that by using a personal health budget, they have more flexibility, choice and control over how money gets spent on their care and support and makes them feel more involved and more positive. A personal health budget enables you to work with a healthcare professional to prioritise the care needs that are important to you and create a care plan that reflects your own personal health and social goals.

  • Who can have a Personal Health Budget?

    Who can have a Personal Health Budget?

    If you are registered to a GP in the Basildon and Brentwood CCG Alliance, are eligible for NHS Continuing Healthcare and are receiving your care at home, you can ask for a personal health budget.

  • I'm eligible so how do I get a Personal Health Budget?

    I'm eligible so how do I get a Personal Health Budget?

    There are six basic steps to organising a personal health budget:

    1. Getting clear information
    Start by talking to the NHS team who currently look after you to find out if you would be eligible for a personal health budget. If you have been referred to the Basildon and Brentwood CCG Complex Cases Team, we can tell you how personal health budgets work for people who receive Continuing Healthcare.

    If you have recently received confirmation that you are eligible for continuing healthcare funding, a package of care and support will be put in place for you. Your needs will be reviewed after three months, and if you are still eligible for continuing healthcare funding at this time, the continuing healthcare nurse will talk to you about the potential benefits of a personal health budget and whether you would be interested in having one.

    2. Understanding your health and wellbeing needs
    Your health and wellbeing needs will be assessed by your multi-disciplinary team (which may include a community nurse, social worker, and other health professionals). The team, supported by a Continuing Healthcare nurse, will discuss with you how the personal health budget may work. An important part of setting a personal health budget is agreeing how the care you receive will benefit your health - your team will talk this through with you.

    3. Working out the amount of money that may be available
    As soon as Continuing Healthcare funding is confirmed at 3 months, your nurse can work out the amount of money that will be available to you in your personal health budget. The amount of money will be based on your health and wellbeing needs and what a conventional package of care would look like. Have a chat with your continuing healthcare nurse if you have any questions or concerns.

    4. Making a personalised care and support plan
    If you choose to have a personal health budget you will need to have a personalised care and support plan (sometime called a Health Support Plan). This is developed by you and your support planner - together you will design a plan that meets your needs and meets NHS funding rules.

    5. Organising care and support
    As soon as your Health Support Plan has been approved, your personal health budget will need to be “activated” – this can be organised in a number of different ways:

    Notional personal health budget – this means the Continuing Healthcare team will buy the services you need directly from the service provider (e.g. a care agency, or if you are in permanent residential accommodation.
    3rd party personal health budget – this means we pass on the money to someone you know, who then organises your care for you (as agreed and described in your Health Support Plan).
    Direct payment – this means we pass on the money directly to you, and you can organise your own care (as agreed and described in your Health Support Plan).
    You can also choose to receive your budget as a combination of the three options above.

    6. Making sure the money is working for you
    Your Continuing Healthcare nurse is responsible for making sure the help and support you are receiving is meeting your needs. As your needs change, so might your personal health budget, to make sure it is giving you the most appropriate support. Eligibility for CHC funding is also reviewed regularly.

  • How will my Personal Healthcare Budget support plan be reviewed?

    How will my Personal Healthcare Budget support plan be reviewed?

    In order to ensure that your care support plan provides you with increased flexibility and choice, is safe, and that public funds will be spent appropriately, all care support plans will be reviewed by the personal health budget lead and the senior management team. It is important to us that the use of personal health budgets is fair and equitable to all.

  • Who do I contact for more information about Personal Health Budgets?

    Who do I contact for more information about Personal Health Budgets?

    If you want to know more or you have any questions about personal health budgets, you can email This email address is being protected from spambots. You need JavaScript enabled to view it. or phone the reception and ask for the CHC team: 01268 594 350.

  • Who do I contact for more information about the Children's Complex Cases Team?

    Who do I contact for more information about the Children's Complex Cases Team?

    NHS Continuing Care is provided to a small group of children and young people with complex health needs up to the age of 18, who need a tailored package of community support.

    You can contact the Children’s Complex Cases Team by 

  • How do I appeal a funded healthcare decision?

    How do I appeal a funded healthcare decision?

    We want you to be happy with the way we assess your needs. If for any reason you are not, we would like to address the issues with you, your relative, friend or representative. We are also able to put you in touch with agencies that can offer support and advice.

    We will help and guide you through our established appeals process. It is not necessary to engage legal counsel to pursue an appeal.

    If you would like to make an appeal, or speak to someone about an ongoing appeal please contact:

Useful links and other websites

The following trusted organisations also provide a wealth of useful information on NHS Continuing Healthcare.

Age UK

Alzheimer’s Society

Beacon - If you would like more information on NHS Continuing Healthcare, you can contact Beacon who will provide 90 minutes of free impartial advice, (NB after the initial 90 minutes there is a financial charge which they will inform you of). Beacon can be contacted on 0345 548 0300 or via their website which has free resources and information.

Healthwatch Essex - They are the independent champion for people who use health and social care services in the Essex. Their job is to make sure that those who run local health and care services understand and act on what really matters to people. They listen to what people like about services and what could be improved. They share what people tell them with those with the power to make change happen. They encourage services to involve people in decisions that affect them. They also help people find the information they need about services in their area. For more information visit their website.

National framework for NHS funded healthcare

National guidance on personal health budgets

Useful CHC documents

DHSC What is NHS Continuing Healthcare easy read guide

 

 

 

 

 

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