NHS Continuing Healthcare claims
NHS Continuing Healthcare ("NHS CHC") is the term given to a package of care provided by the NHS when a person is not in hospital but has a 'primary health need.' Effectively, if someone qualifies for NHS CHC, the NHS must pay for their care, regardless of the individuals own financial circumstances as it is not means tested. This care can be provided in a nursing or care home setting or in the individuals own home.
In order to be eligible for NHS CHC, a checklist should first be completed to see whether the individual needs a full assessment for NHS CHC. If it appears that a full assessment should be performed then a multidisciplinary team from the local Clinical Commissioning Group will perform this. They will create a decision support tool which will cover eleven different factors such as behaviour, nutrition, mobility and breathing. These will be rated from priority or severe to no needs. The outcome of the decision support tool will then enable the multidisciplinary team to either recommend to the Clinical Commissioning Group that NHS CHC funding is or is not provided.
It is important that the individual is involved in the completion of the Decision Support Tool if they are able to. If they are not able to cooperate in the completion of this, then a family member or attorney under a Health and Welfare Lasting Power of Attorney should be invited to attend and provide their views on the individual's needs. It is always important to consider making Lasting Powers of Attorney to cover this eventuality.
If an individual is not recommended for NHS CHC and they or their representative feel that this is incorrect, it is possible to contact the Clinical Commissioning Group for an independent review within 6 months of the initial decision. The deadline to make retrospective claims has now passed and the NHS will only consider these in exceptional circumstances. Clapham and Collinge have a wealth of experience in assisting individuals, their families and attorneys in appealing NHS CHC decisions and dealing with the NHS on their behalf.
If you would like to find out more about NHS CHC and appealing any decisions or to find out how the team can assist you, contact us today on 01603 693500 or email us using the 'Make an enquiry' form.