Navigating the landscape of long-term healthcare can be daunting, especially when trying to understand the financial support available. For individuals with complex health needs in the UK, NHS Continuing Healthcare (CHC) offers a route to fully funded care arranged and paid for by the National Health Service. A crucial first step in accessing CHC is often the Nhs Funded Nursing Care Checklist Tool. While the term might seem to point directly to NHS Funded Nursing Care (FNC), it’s important to clarify its role within the broader CHC assessment process. This guide will provide a comprehensive overview, ensuring you understand how this tool fits into accessing the right level of NHS support.
NHS Continuing Healthcare: What is it?
NHS Continuing Healthcare is a package of care provided to adults in England, arranged and funded solely by the NHS. It’s designed for individuals with complex, intense, and unpredictable health needs that have arisen as a result of disability, accident or illness. This care can be delivered in various settings outside of a hospital, such as your own home or a care home.
Eligibility for CHC is based on your care needs, not on any specific diagnosis or condition. The NHS needs to determine if your primary need for care is health-related. If it is, and those needs are complex, intense and ongoing, you may be eligible for CHC.
The Initial Checklist: Your First Step in the CHC Assessment
The “NHS funded nursing care checklist tool” often refers to the initial checklist assessment used to determine if an individual should proceed to a full assessment for NHS Continuing Healthcare. This checklist is not specifically for NHS Funded Nursing Care, but rather acts as a screening tool for CHC eligibility.
Integrated Care Boards (ICBs), the NHS bodies responsible for commissioning local health services, are required to assess individuals for CHC if it appears they might need it. For most people, this starts with the initial checklist.
Who Completes the Checklist?
The initial checklist can be completed by a variety of healthcare professionals, including:
- Nurses
- Doctors
- Other healthcare professionals
- Social workers
Crucially, you should be informed that you are being assessed and understand what the assessment involves.
What Happens After the Checklist?
The outcome of the checklist determines the next steps:
- Not Eligible for Full Assessment: If the checklist indicates that you do not meet the criteria for a full CHC assessment, you will be informed that you are not eligible to proceed further with the CHC process. You may then be directed to your local council to discuss potential social care support.
- Referral for Full Assessment: If the checklist suggests you might be eligible for CHC, you will be referred for a full assessment of eligibility. It’s vital to understand that referral for a full assessment does not guarantee CHC eligibility, but it opens the door to a more detailed evaluation of your needs.
The professionals completing the checklist are required to document their reasons for the decision in writing, sign, and date it. You are entitled to receive a copy of the completed checklist.
Understanding the Full NHS Continuing Healthcare Assessment
If the initial checklist indicates a potential need for CHC, a full assessment is the next stage. This comprehensive assessment is carried out by a multidisciplinary team (MDT).
The Multidisciplinary Team (MDT)
The MDT consists of at least two professionals from different healthcare disciplines. Ideally, the team will include health and social care professionals already involved in your care. You should be informed who is coordinating your CHC assessment.
Areas Assessed by the MDT
The MDT will assess your needs across twelve key domains:
- Breathing
- Nutrition (Food and Drink)
- Continence
- Skin (including wounds and ulcers)
- Mobility
- Communication
- Psychological and Emotional Needs
- Cognition (Understanding)
- Behaviour
- Drug Therapies and Medication
- Altered States of Consciousness
- Other Significant Care Needs
For each of these areas, your needs are assigned a weighting: “priority,” “severe,” “high,” “moderate,” “low,” or “no needs.”
Eligibility Criteria Based on Needs
Eligibility for CHC is primarily determined by the level and combination of your assessed needs. Generally:
- Priority Needs: Having at least one “priority” need often indicates eligibility.
- Severe Needs: Having “severe” needs in at least two areas can also lead to eligibility.
- Combination of Needs: You may also be eligible with a “severe” need in one area plus other needs, or with multiple “high” or “moderate” needs, depending on their nature, intensity, complexity, and unpredictability.
The MDT will consider your overall needs and how they interact, along with risk assessments, to determine CHC eligibility. Your views and the views of your carers are also taken into account. Following the assessment, you will receive a copy of the decision documents, including clear reasons for the outcome.
Fast-Track Assessment for Urgent Needs
In situations where health is rapidly deteriorating and an individual is nearing the end of life, the NHS continuing healthcare fast-track pathway should be considered. This pathway aims to expedite the process, typically putting a care and support package in place within 48 hours.
What if You Are Not Eligible for NHS Continuing Healthcare?
If you are not eligible for NHS Continuing Healthcare, it’s not the end of the road for NHS support. You may be eligible for NHS-Funded Nursing Care (FNC) if you are assessed as requiring nursing care in a care home registered to provide nursing care.
NHS-Funded Nursing Care (FNC) Explained
NHS-Funded Nursing Care is a contribution from the NHS towards the cost of your registered nursing care within a care home. This funding is available regardless of who is paying for the rest of your care home fees. It’s a separate form of NHS support from CHC and addresses the specific cost of nursing care within a care home setting.
Key Takeaways about the NHS Funded Nursing Care Checklist Tool (and CHC Assessment)
- The term “NHS funded nursing care checklist tool” often refers to the initial checklist for NHS Continuing Healthcare, not a checklist specifically for FNC.
- The initial checklist is a screening tool to determine if a full CHC assessment is necessary.
- Eligibility for CHC is based on complex, intense, and unpredictable health needs, not solely on a diagnosis.
- The full CHC assessment is carried out by a multidisciplinary team who evaluate needs across 12 domains.
- If ineligible for CHC, you may still be eligible for NHS-Funded Nursing Care to contribute towards nursing care costs in a care home.
Understanding the process and the tools involved is crucial for accessing the NHS support you or your loved one may be entitled to. If you believe you or someone you know may be eligible for NHS Continuing Healthcare, initiating the initial checklist assessment is the first important step. For further guidance and independent advice, organizations like Beacon offer free helplines and resources to navigate the complexities of NHS Continuing Healthcare.
