Continuing healthcare funding is available to meet the cost of a care for an individual where their primary need for care is a health one
Contact our team of experts at Compass Continuing healthcare today to see if your relative is entitled to continuing healthcare funding to pay for their care home fees in full. Our office number is 0121 227 8940. Alternatively please complete our FREE online assessment and we will contact you.
Continuing healthcare funding is available to meet the cost of a care for an individual where they are not in hospital and their primary need for care is a health need. Where Continuing Healthcare funding is provided the NHS will pay the full cost of the care fees, whether those are for carers in the individual’s home, or the residential or nursing home costs. It is not a requirement for the individual to be in a nursing home, continuing healthcare funding can be provided regardless of the location of the patient.
The requirement for an entitlement for continuing healthcare funding is that the individual’s need for care is primarily a health need. In order to satisfy the criteria the individual must have health needs across a spectrum of different domains that includes areas such as challenging behaviour, cognitive function, psychological and emotional needs, mobility, altered state of consciousness, breathing, feeding and other key areas.
The assessment process is that a preliminary assessment known as a continuing healthcare funding checklist is completed. If this assessment identifies that the individual has health needs, and this is determined by scorings of A, B or C in key areas and the individual securing 2 or more A scores, 1 A and 4 B’s or 5 or more B scores, then they progress to a full assessment.
This second stage assessment is known as a decision support tool assessment. It should be completed by a multi-disciplinary team of clinicians. The decision support tool, or DST, assessment considers similar areas or domains of the individuals health needs and scores them on the basis of no needs, low, moderate, high, severe and for certain domains, priority. Having scored the individual in all domains the DST then asks whether when looking at the needs as a whole are they sufficiently, complex, intense, and unpredictable in their nature to warrant a determination that the primary need for care is a health need.
It is clear therefore to see there is an element of subjectively to the assessment and there is scope for an individual’s needs to be underscored so that they do not satisfy the criteria and secure eligibility for continuing healthcare funding.
For this reason it is our view at Compass continuing Healthcare that in order to stand the best chance of success of securing continuing healthcare funding from the earliest opportunity it is necessary to build an individual’s case with reference to their independent medical records and cross reference to the criteria set out by the Department of Health.
In this manner we are able to comprehensibly display an individual’s entitlement to ensure that continuing healthcare funding so that there is no possibility for the needs to be underscored and funding denied.
We can assist from day one while the patient is still in hospital before a decision has been made. Why wait until a negative decision has been made when we can assist from the outset and have an influence in ensuring the only decision is a positive one.
If your relative is paying for care, or they are due to be discharged from hospital to a care home, contact us today for advice regarding your options and how we can assist. You can complete our FREE, CONFIDENTIAL assessment here and a member of our team will contact you, or you can contact us directly on 0121 227 8940.
Author: Tim Davies LLB