The CCG, along with other CCGs in Lancashire has created a draft policy to ensure that NHS Continuing Healthcare is managed in a fair, open, transparent and safe way, while at the same time ensuring that the process and the decisions make the best use of the available NHS money and health service resources.
We would like to know your views about this draft policy. We are seeking your comments from now until the 7th November 2016.
The draft policy is a brand new policy. It does not replace a previous policy. As the demand for NHS continuing healthcare has increased, it is clear that we need a consistent approach, across Lancashire to avoid creating a postcode lottery where decisions are made are inconsistent and as a result are not fair for patients. It applies to those aged 18 years and above only.
NHS continuing healthcare is the name given to a package of care which is arranged and funded solely by the NHS for individuals outside of hospital who have ongoing health care needs. An individual can receive NHS continuing healthcare in any setting, including their own home, in a care home or specialist placement.
NHS continuing healthcare is fully funded by the NHS, unlike support provided by local authorities for which a financial charge may be made depending on your income and savings.
If an individual is found to be eligible for NHS continuing healthcare and wishes to be cared for in their own home, this means that the NHS will pay for healthcare (e.g. services from a community nurse or specialist therapist) and associated social care needs (e.g. personal care and domestic tasks, help with bathing, dressing,). In a nursing or care home, the NHS also pays for care home fees, including board and accommodation.
If an overall assessment of care needs highlights a ‘primary health need’, this indicates eligibility for NHS continuing healthcare. Once eligible for NHS continuing healthcare, care will be funded by the NHS, this is however, subject to regular reviews, and, should a person’s needs change, the funding arrangements may also change. Whether someone has a ‘primary health need’ is assessed by a multi-disciplinary team using a national tool.
Commissioning Groups (CCGs) assumed statutory responsibility for NHS Continuing Healthcare from 1 April 2013. The Continuing Healthcare team (CHC) for the CCG is subcontracted to the NHS Midlands and Lancashire Commissioning Support Unit CSU.
This policy describes the work of the Midlands and Lancashire Commissioning Support Unit (CSU) Continuing Healthcare Team (CHC) commissioned by the CCG, to provide care for people who have been assessed as eligible for NHS Continuing Healthcare. It describes how the CSU will support the choices and preferences of individuals while at the same time balancing the need for the CCG to commission care that is safe and effective and makes the best use of available resources. It is also necessary to have a policy which supports decisions that are consistent, equitable and compliant with the CCG’s obligations under equality legislation. These decisions need to provide transparency and fairness in the allocation of resources.
Application of this policy will ensure that decisions about care will:
- Be robust, fair, consistent and transparent
- Be based on the objective assessment of the person’s clinical need, safety and (where a person lacks mental capacity to make decisions about their care) their best interests
- Have regard for the safety and appropriateness of care to the individual and staff involved in the delivery
- Involve the person and their family/representative wherever possible
- Take into account the need for the CCG to allocate its financial resources in the most cost effective way;
- Support choice to the greatest extent possible in view of the above factors.
Access to NHS services depends upon clinical need, not ability to pay. The CCG will not charge a fee or require a co-payment from any NHS patient in relation to the assessed needs. The principle that NHS services remain free at the point of delivery has not changed and remains the statutory position under the NHS Act 2006.