CHC FUNDING | July 2022 | NHS Criteria | Complete Guide (2024)

FAQs

What qualifies you for CHC funding? ›

To get NHS continuing healthcare you must: have ongoing significant physical and/or mental health needs, and having taken account of all your needs, it can be said that the main aspects or majority part of the care you need is focused on addressing and/or preventing health needs.

' A score of C shows that the individual is continent of urine and faeces, or that day-to-day continence care is simple and routine. Anyone with two or more A scores, or a total of five scores across A and B will be referred for a full assessment. This is a more detailed and lengthy process.

Completion of a CHC Checklist should be triggered automatically in certain circ*mstances, such as: when the individual is ready for discharge from hospital prior to a local authority funding assessment (NB. changes to hospital discharge due to COVID mean that Checklists are currently completed after discharge)

Some people with dementia qualify for NHS continuing healthcare (CHC) funding to meet the costs of some of their care needs, but the application process isn't always easy. Here, we explain the facts you need to know about CHC and advice from our dementia specialist Admiral Nurses.

The CHC assessment is divided into 12 care domains: • behaviour • cognition • psychological and emotional needs • communication • mobility • nutrition • continence • skin integrity (including wounds, ulcers, tissue viability) • breathing • drug therapies and medication: symptom control • altered states of consciousness ...

Does dementia qualify for NHS continuing healthcare? If you are living with dementia and have complex health and care needs, you may be eligible for NHS continuing healthcare. Being diagnosed with dementia does not automatically make you qualify as it depends on the severity and complexity of your health needs.

To qualify for Continuing Healthcare funding, it must be proven that you have a 'primary health need'. This means that your care requirements are primarily for healthcare, rather than social or personal care needs. This is usually judged via a two-step assessment process; a Checklist followed by a Full Assessment.

A decision about eligibility for a full assessment for NHS continuing healthcare should usually be made within 28 days of an initial assessment or request for a full assessment.

The total number of people assessed for NHS CHC was 39,455 in Q3 2019/20. Of these, 14,602 were via the Standard NHS CHC assessment route and 24,853 were via the Fast Track assessment route. The total number of people assessed as eligible for NHS CHC was 28,369 in Q3 2019/20.

A positive Checklist means that the individual requires a full assessment of eligibility for NHS Continuing Healthcare. It does not necessarily mean that the individual will be found eligible for NHS Continuing Healthcare (refer to paragraphs 104-107 of the National Framework).

Is there a cap on CHC funding? ›

There is no limit to the amount of CHC Funding you can receive or for how long. However, if someone's care needs change, then the need for CHC Funding may change and be withdrawn. An CHC assessment will usually be carried out annually, but if care needs change they can be carried out earlier.

What does CHC funding pay for? Continuing healthcare funding will cover all your health needs. This includes any care home fees, or the cost of health and social care professionals that come to your home. However, it does not cover a social or personal healthcare need.

If you have a severe mental impairment of intelligence or social functioning which appears to be permanent, for example Alzheimer's or dementia, then you don't have to pay Council Tax. This is known as disregarded. The person must be certified by a doctor as severely mentally impaired and entitled to certain benefits.

Despite dementia being a medical condition, the needs of people with dementia are often seen as social care rather than healthcare needs. As a result, thousands of people with dementia spend substantial amounts of money on social care they need as a result of their medical condition.

In most cases, the person with dementia will be expected to pay towards the cost. Social services can also provide a list of care homes that should meet the needs identified during the assessment.

A care package is a combination of services put together to meet a person's assessed needs as part of a care plan. The assessment or review is done by a social care professional. It says exactly what that person needs in the way of care, services or equipment to live their life.

How does NHS continuing healthcare affect benefits? If you're getting NHS continuing healthcare and living in your own home, your Attendance Allowance, Disability Living Allowance and Personal Independence Payment remain the same.

Any clinician can complete a fast track assessment on behalf of the patient and submit the same to the Clinical Commissioning Group.

If Cancer is not a social care problem, neither is Dementia. Dementia itself is not a disease but is used to describe a group of symptoms that occur when brain cells stop working properly. These are the main types of Dementia but all others are also related to a medical condition.

Lewy body dementia causes a progressive decline in mental abilities. People with Lewy body dementia might have visual hallucinations and changes in alertness and attention. Other effects include Parkinson's disease signs and symptoms such as rigid muscles, slow movement, walking difficulty and tremors.

When should a person with dementia go into a care home? ›

If a person's dementia has progressed far enough that they need more care and support than you can provide, it may be time for them to go into a care home. At this point, they may need 24-hour care. Dementia is progressive, meaning the person with the condition will require more care and support as time goes on.

NHS continuing healthcare is an ongoing package of health and social care that is arranged and funded solely by the NHS where an individual is found to have a primary health need. Such care is provided to an individual aged 18 or over to meet needs that have arisen as a result of disability, accident or illness.

You will not be entitled to help with the cost of care from your local council if: you have savings worth more than £23,250 – this is called the upper capital limit, or UCL, and will rise to £100,000 from October 2023. you own your own property (this only applies if you're moving into a care home)

People who are eligible for continuing healthcare should have their funding backdated to the 29th day after the date on which the original referral was received.

As long as all the required information is submitted, it usually takes 30 working days from receiving an application to a decision, but it can often be sooner. Urgent cases can be processed more quickly if needed.

Once your continuing healthcare (CHC) assessment has taken place, the NHS health and social care professionals involved with your care will recommend whether you are eligible for funded care. This recommendation is forwarded to the Integrated Care Board (ICB) responsible for funding in your area.

The Decision Support Tool – commonly referred to as the DST – is the form that must be completed by assessors during a Full Assessment for NHS Continuing Healthcare.

If you, or a loved one, has paid the full cost of nursing care provision (i.e. nursing care has been self-funded), but you can demonstrate you or your loved meet the criteria for the FNC, then upon assessment it is perfectly reasonable to request that the Clinical Commissioning Group (CCG) backdates the FNC you should ...

If an individual's condition is deteriorating rapidly, they may be approaching the end of their life, and a “fast track” continuing care assessment may be applicable to allow an appropriate care and support package to be put in place as soon as possible.

FNC is not means tested, so your income and savings have no bearing on whether you can get it or not and it does not matter if you are a self-funder or if your local authority is paying for your care.

What is a negative checklist? ›

A negative Checklist means the individual does not require a full assessment of eligibility and they are not eligible for NHS Continuing Healthcare.

Checklists are assessment tools that set out specific criteria, which educators and students may use to gauge skill development or progress.

Completion of a Decision Support Tool (DST) Upon completion of a positive checklist, a DST is then completed. A DST is an assessment tool used to investigate whether a person's needs are primarily healthcare needs that would be eligible for NHS continuing healthcare.

The new charging policy framework

The cap will be set at £86,000 in October 2023. This will provide financial protection from unlimited care costs and, as a result, give people peace of mind from knowing that they will keep more of their assets when paying for their care.

A review of NHS Continuing Healthcare takes place after the first three months, then at least once a year thereafter. Of course, there will be times when the withdrawal of funding is justified, if the intensity or complexity of care needs have genuinely reduced.

The government have stated that the new social cap will be funded by both national insurance contributions and dividend tax rate increase. The national insurance increase of April 2022 will count towards the funding of the cap. Only those who are working above the state-pension age levy qualify to contribute.

Your local authority can also pay for your end of life care. A general practitioner or a hospital social worker can refer you to the local authority, or you can get in touch with them yourself. Before taking over the cost of care needs, the local authority will assess your care needs.

The Continuing Healthcare assessment, sometimes known as a Full Assessment, is a detailed appraisal of your care needs – using a form called the Decision Support Tool (or DST) – to decide if you are eligible to receive NHS Continuing Healthcare (CHC).

The Decision Support Tool is usually referred to as the DST. The assessment will consider a range of possible needs, such as mobility, nutrition and behaviour. The person being assessed will be invited to take part and they may involve members of their family too, if they wish.

The average life expectancy figures for the most common types of dementia are as follows: Alzheimer's disease – around eight to 10 years. Life expectancy is less if the person is diagnosed in their 80s or 90s. A few people with Alzheimer's live for longer, sometimes for 15 or even 20 years.

What qualifies as a severe mental impairment? ›

What is severe mental impairment? The law says that a person is severely mentally impaired if they have a severe impairment of intelligence and social functioning (however caused), which appears to be permanent. This is likely to include people diagnosed with dementia or Alzheimers.

Nearly 80% of eligible households received the government's £150 council tax rebate in the first 3 months to help with the cost of living, figures published today show. A total of more than £2 billion has been handed to 15 million households in England under the scheme.

Advanced dementia is a leading cause of death in the United States. Features include profound memory deficits (e.g., inability to recognize family), minimal verbal communication, loss of ambulatory abilities, the inability to perform activities of daily living, and urinary and fecal incontinence.

Some people with dementia qualify for NHS continuing healthcare (CHC) funding to meet the costs of some of their care needs, but the application process isn't always easy.

Families often make the mistake in thinking that Dementia gives an absolute entitlement to CHC Funding. It doesn't! The important point to note is that the mere diagnosis of a condition such as Dementia, does not automatically entitle an individual to qualify for NHS Continuing Healthcare Funding.

Your mum should not have to sell her house while she's alive to fund her care costs. She (or you on her behalf as an attorney) may be able to arrange a Deferred Payment Agreement (DPA) with the local authority.

Home care is often recommended by experts through end of life. However, every family and situation is different, so permanent home care may not always be possible. Research shows keeping a loved one with dementia at home helps them be happier and live longer; however, it is most impactful when introduced early.

If you're living with dementia, you may be entitled to a disability or mobility benefit. These include Attendance allowance, PIP and Disability living allowance.

NHS continuing healthcare isn't means-tested, so it doesn't depend on how much money you have. Instead, it depends on how your illness affects you and what help you need. NHS continuing healthcare is only for adults.

There is no limit to the amount of CHC Funding you can receive or for how long. However, if someone's care needs change, then the need for CHC Funding may change and be withdrawn. An CHC assessment will usually be carried out annually, but if care needs change they can be carried out earlier.

Who can complete CHC fast track? ›

Any clinician can complete a fast track assessment on behalf of the patient and submit the same to the Clinical Commissioning Group.

Despite dementia being a medical condition, the needs of people with dementia are often seen as social care rather than healthcare needs.

To qualify for Continuing Healthcare funding, it must be proven that you have a 'primary health need'. This means that your care requirements are primarily for healthcare, rather than social or personal care needs. This is usually judged via a two-step assessment process; a Checklist followed by a Full Assessment.

Continuing Healthcare Funding is not means tested; meaning that it doesn't matter what your income is or what savings you have, if you meet the criteria, you are entitled to free NHS CHC funding.

The cost of NHS-funded nursing care

NHS-funded nursing care is paid at the same rate across England. In May 2022, the rate was set at £209.19 a week (standard rate) and will be backdated to 1 April 2022.

The new charging policy framework

The cap will be set at £86,000 in October 2023. This will provide financial protection from unlimited care costs and, as a result, give people peace of mind from knowing that they will keep more of their assets when paying for their care.

The total number of people assessed for NHS CHC was 39,455 in Q3 2019/20. Of these, 14,602 were via the Standard NHS CHC assessment route and 24,853 were via the Fast Track assessment route. The total number of people assessed as eligible for NHS CHC was 28,369 in Q3 2019/20.

A care package is a combination of services put together to meet a person's assessed needs as part of a care plan. The assessment or review is done by a social care professional. It says exactly what that person needs in the way of care, services or equipment to live their life.

This is done using the NHS Continuing Healthcare Fast Track process ('Fast Track Pathway Tool for NHS Continuing Healthcare'). Essentially, it's a fast assessment to get NHS funding in place as quickly as possible – usually within 48 hours of assessment.

Once approved, a care package should be in place within 28 days. People with a package of care funded by CHC are re- assessed after three months and then annually to review whether or not they still require support.

Can CHC funding be backdated? ›

People who are eligible for continuing healthcare should have their funding backdated to the 29th day after the date on which the original referral was received.

In most cases, the person with dementia will be expected to pay towards the cost. Social services can also provide a list of care homes that should meet the needs identified during the assessment.

If a person's dementia has progressed far enough that they need more care and support than you can provide, it may be time for them to go into a care home. At this point, they may need 24-hour care. Dementia is progressive, meaning the person with the condition will require more care and support as time goes on.

If Cancer is not a social care problem, neither is Dementia. Dementia itself is not a disease but is used to describe a group of symptoms that occur when brain cells stop working properly. These are the main types of Dementia but all others are also related to a medical condition.