What is Continuing Healthcare for adults?
Continuing Heathcare is the name given to the care for adults with complex needs that cannot be met by existing services in their community. This could be as a result of a disability, accident or illness.
The National Framework for Continuing Healthcare (2012) sets out how people eligible for Continuing Healthcare should be supported by their local Clinical Commissioning Group and Local Authority.
The Framework is clear that the needs of adults are best met using a joined-up approach between health and social care.
This allows those with complex needs to live an ordinary life as possible in relation to their needs
What types of continuing health care are available?
Resources required can vary depending on your needs, but they may include:
- Specialist equipment
- Short break support at home
- Short break support in the community
- Nursing/carer support in your home and various other settings
You may discuss what you feel you require with your health assessor or social worker.
How is Continuing Healthcare eligibility decided?
If your health needs change, a professional working with you will arrange to meet with you to complete a checklist which will determine whether you are eligible for consideration for Continuing Healthcare funding.
The checklist will be completed by a qualified health professional who is specialised in the area of your needs.
If you are found not to be eligible for consideration for Continuing Healthcare, a clear explanation of the reason for this decision will be given to you. If this happens, any care needs will be met by existing services.
If you are found to be eligible for consideration for Continuing Healthcare, a referral will be made to the Continuing Healthcare team and a Funded Nurse Practitioner will be allocated to you.
They will arrange with you, your family/carer and relevant professionals a meeting to complete the decision support tool. There will be a recommendation made from the outcome of this meeting as to whether your needs meet the criteria for Continuing Healthcare funding.
The Continuing Healthcare ratification process
Our assessment and relevant information will be presented to senior managers by the Nurse Practitioner. The panel will make a decision regarding eligibility and a discussion will take place about the package of care that you need. You will receive a letter regarding the outcome and you can request a copy of the decision support tool.
Once in place, the level of support will be reviewed in 12 weeks and then annually to ensure that it continues to meet your needs.
Disputing decisions
If you wish to dispute the outcome of the decision support tool, details of how to appeal will be included in the outcome letter that will be sent to you to enable you to follow NHS Warrington Clinical Commissioning Group’s complaints process.
Contact
For more information or to have an informal discussion about this process, please contact: The Warrington Continuing Healthcare Team on 01925 843697
