Continuing Health Care - Some info. - PSP Association

PSP Association

9,152 members11,289 posts

Continuing Health Care - Some info.

Kevin_1 profile image
8 Replies

Well we are up for our annual CHC re-assessment today. So I have been reading up a little.

I am gradually working my way through intricacies of Continuing Health Care.

I am drawing heavily on Angela Sherman’s work from her website and her book.

She points out that she refers to the elderly throughout her work, but that the information is completely valid for any age group.

Angela had a fight to get Continuing Health Care for one of her parents and now she has this superb website and works as an advocate helping people win their cases.

caretobedifferent.co.uk/abo...

She has published a superb briefing paper available for free here.

caretobedifferent.co.uk/abo...

Just scroll down to "download our free 17 page eGuide. "

It is simple and clearly written. It really is worth a read.

Here are a few key bits of information from the eGuide:

Social Care provided by the Social Services is means tested.

Continuing Health Care provided by the NHS is not means tested and it is completely free at the point of delivery.

She points to the incorrect, and sadly common, comment from the NHS saying that washing and bathing are Social Care Needs and that you need to go to the Social Services and thus the means tested system.

The condition for Continuing Health Care is that the applicant needs care primarily for health reasons. Not that all needs are nursing needs.

Questions about finances should never be asked in a CHC assessment. It's not means tested and so that is non of their business.

If you qualify for CHC you qualify for all of the needs to be met. If they try to part fund and refer you for Social Care (means tested) they are not following the law.

You have a right to an assessment for CHC (get your GP to refer you). If they do a brief visit and say you don’t qualify and there's no point doing an assessment, stick to your guns and say you want an assessment because without it neither you nor them would really know.

Social Care:

There is a good para about social care and reasons why your home should not always be included in the means test. One is your partner lives there and another relative over Sixty lives there. There are other reasons too.

Staying with Social Care only the person requiring Social Care should have their assets assessed not the spouse’s assets or joint assets.

Back to CHC:

“If your relative needs full time care AND they have any degree of

health needs or nursing care needs, then they should be assessed for

NHS Continuing Healthcare funding.”

“The assessment process

There are two main stages to the assessment process. The first stage is called a ‘Checklist assessment’. This initial Checklist does not determine eligibility, but instead determines whether a person should go through to stage two, the full assessment.

At the Checklist stage many people are simply told they ‘don’t qualify’, and yet their needs may well have been assessed without due regard to the National Framework guidelines and the Checklist assessment criteria. This also happens at stage two. You can appeal. (Stage two is sometimes known as ‘the DST’, which stands for Decision Support Tool; this is the name of the form used during stage two.)”

Read more about the various stages of the assessment process here.

If you qualify for CHC you qualify for everything. All needs should be met through CHC.

Angela has noted that she is seeing more cases of funding being withdrawn. She believes this is often based on Trusts wanting to protect limited funds and poor assessments. Read that section if that is you. There is an appeal process.

Finally there is a section on Funded Nursing Care (FNC):

This is only for those who do not qualify for CHC.

Essentially it is a new and rather worrying development where the person pays for some of their Nursing Care.

You should always be assessed for CHC before FNC is considered.

Well I guess that has got me in the mood to face the assessing Nurse!

I hope this is useful as an opener on the subject for those who don't know.

I will post more when I have finally digested the manual. Lactulose is standing by.

Good luck to all.

Kevin

Written by
Kevin_1 profile image
Kevin_1
To view profiles and participate in discussions please or .
Read more about...
8 Replies
Kevin_1 profile image
Kevin_1

Assessment over.

Outcome?

A full review... Well that will take six months to arrange!

Now back to plan 'A'

Stressful or what!

Satt2015 profile image
Satt2015 in reply to Kevin_1

I) another brilliant post Kevin, well done and thank you for taking your time again to keep us all informed

2) very stressful, I'm very sorry, you and Liz deserve the chc as do many others!

3) bloody rules and regulations stink!!

X

NannaB profile image
NannaB in reply to Kevin_1

I'm a bit confused. If you are getting CHC, why have you got to have a full review and what was the reassessment you had today for? We were granted CHC 3 years ago and every year we have a cosy chat ( review) where the original form is re visited to see what changes have taken place. A very painless, seemingly relaxed conversation with a cup of tea to help and a "Thanks, see you next year I hope" before goodbye.

Before the first assessment I downloaded "Decision Support Tool for NHS Continuing Care. The caretobedifferent guide is a lot easier to read than the dozens in the support tool but it gives the professionals guide as to what to look for and how to score the needs. Before the assessment I had filled in the form myself, how I thought it should be completed (took hours) and managed to get some of the decisions the professionals made changed. I wouldn't have been able to do that without seeing the tool first. Of course I didn't have my form with me at the meeting but remembered most of what I had put. When they sent me the completed form before it went to the panel, I added a long letter pointing out how I disagreed with the results of the section on behaviour and on receipt of my letter, was told they had changed it from low to priority.

Good luck with plan A.

X

Kevin_1 profile image
Kevin_1 in reply to NannaB

Yes, I remember you saying about the decision support tool. That sounded like a really good idea.

Maybe someone could do post on that? ;)

We were taken off a Personal Budget and placed on 'Fast Track' to enable an urgent respite break. This was the three month later interview reviewing that after eight months.

So now we have a green light to go back through the CHC assessment process despite having CHC in place on Fast Track.

Simultaneously we are well into the process of being submitted to the funding panel for CHC on a Personal Budget (plan A)... Are they confused?

I do know we have been stacked in a slow process since March!

L needs more services now.

X

NannaB profile image
NannaB in reply to Kevin_1

Whew! Sounds very complicated.

X

Kevin_1 profile image
Kevin_1 in reply to NannaB

It might seem like that.

It's certainly a bit of work!

It is the way clinicians view the 'need' world.

It's the sort of thing that once you get started it is rather obvious.

As I said, its not essential.

X

Kevin_1 profile image
Kevin_1 in reply to Kevin_1

Oh, sorry wrong thread - I guess I am tired now.

From reading it seems quite a number of folk just get the door closed in their faces for CHC or they get pushed in whole or in part across to the means tested Social Services route.

I guess this is a bit of a flag to say the way it should be.

x

Kevin_1 profile image
Kevin_1 in reply to Kevin_1

And finally getting the reply right... bucket over head again.

Not complicated they have got us in two different funding streams.

The agency which came today are tasked with a backlog of 'Fast Track' assessments. FAst Track is used when someone needs to be got out of Care or hospital... it could just be a broken hop and temporary. Their only avenue is to recommend cessation of Fast Track funding or progression to full assessment for CHC.

On the other hand I've already worked hard to salvage our older funding stream on a personal budget. That is going to be pushed forward.

The two will crash into each other at the confluence I expect. More phone calls tomorrow. lol

Did I get it right this time?

Can I take the bucket off my head now?

Kevin

xx

You may also like...

Continuing Health Care - Applications and Issues

Continuing Health Care funding for home care or respite is not always easy to get. CHC is free at...

Mum PSP , continuing health care.

last week and we did get continuing health care for her last six months. Today CHC phone me and ask...

Preparing for your Continuing Health Care Assessment

proper CHC assessment is scored and doing this means that they have the information to get the...

Continuing Health Care. (CHC)

anyone else who is going through the assessment process for CHC at the moment. Peter3.

Continuing Health Care

Marie for advice regarding CHC a while back. My brother has now been assessed three times (once...