A brief guide to NHS Funded Continuing Healthcare for NHS Norfolk

An outline of NHS Funded Continuing Healthcare

Continuing Care is the provision of care over an extended period of time to a person aged 18 years or over that 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.

What does it mean to the patient?

To receive NHS Funded Continuing Healthcare, a person must be assessed as meeting the eligibility criteria defined in the Department of Health Framework (October 2007). People who meet the criteria will always have complex, unpredictable or deteriorating conditions and have extensive health care needs.

Where is it provided?

People may receive NHS Funded Continuing Healthcare in an NHS funded bed in a suitably registered nursing care home, a specialist unit or in their own home.

How will the person’s needs be assessed?

The decision that someone is eligible for NHS Funded Continuing Healthcare will be made following assessment by health professionals (e.g. doctors, nurses, social workers, occupational therapists). The patient and their carers will be involved in the assessment in a way that is appropriate to their circumstances. 

At the end of the assessment the health professionals along with the individual and the carers will make a recommendation of eligibility which will then be ratified at a quality review panel. Funding, if eligible, will then start from the date of first consideration of need for assessment. If eligibility is not agreed then the assessment findings will be shared with Social Services for funding consideration.

How often will the need be assessed?

Everyone who receives NHS Funded Continuing Healthcare will be reassessed no less than once a year and possibly more frequently if health needs change. It must be noted that as a person’s needs change, then their eligibility for NHS Funded Continuing Healthcare might also change. Funding may then be met by Social Services with a possible addition of Funded Nursing Care and means tested family contribution.

What to do if you are unclear about anything?

If you need clarification on any aspect of NHS Funded Continuing Healthcare, please contact the Continuing Healthcare Team. The full address is below.

How can you contest any Continuing Healthcare decision?

If a patient or their carer is unhappy with any Continuing Healthcare decision and cannot obtain a solution which they see as satisfactory they should contact:

Continuing Healthcare Department,
Quality Assurance Commissioner,
NHS Norfolk, Lakeside 400,
Old Chapel Way, Broadland Business Park,
Thorpe St Andrew, Norwich NR7 0WG
Tel: (01603) 257249

This enables the commissioners to review how NHS Funded Continuing Healthcare criteria have been applied to you or to your relative.

What will happen if you request a review?

If you request a review, you will be advised of the process to be followed and be given help to try and reach an agreement between you and the relevant people in the local health services.
If this is unsuccessful, arrangements will be made for your case to be considered by a Continuing Healthcare Review Panel consisting (amongst others) of an independent chairperson and a group of suitably qualified professionals. The results of this review will be reported to the Continuing Healthcare Department and will then be sent, in writing, to the person who requested the review.

What can you do if you are still not happy following a review?

If you are dissatisfied with the outcome of the consideration of your case by the Continuing Healthcare Review Panel you can use the Strategic Health Authority Independent Review Panel. Contact the above Quality Assurance Commissioner for further information about how to do this.

Summary

Further information

If you wish to discuss your position or to take independent advice on what to do you can speak to the NHS Norfolk Patient Advice and Liaison
Service (PALS) on: 0800 587 4132, or email: pals@norfolk.nhs.uk

 Continuing Healthcare Department, 
 Lakeside 400,
 Old Chapel Way,
 Broadland Business Park,
 Thorpe St. Andrew,
 Norwich,
  NR7 0WG.
 
 Tel: (01603) 257243