A useful glossary of key terms associated with the NHS continuing healthcare funding process
|CCG||Clinical Commissioning Group|
|DOH||Department of Health|
|NHS CHC||NHS continuing healthcare|
|DST||Decision Support Tool|
|DH||Department of Health|
|FOI||Freedom of Information Request|
|IRP||Independent Review Panel|
NHS continuing healthcare / NHS CHC – is the free package of healthcare provided and funded by the NHS to individuals who have significant and ongoing primary healthcare needs. This package of care can be received in any setting outside of hospital including care homes, hospices or within a patient’s own home.
The National Framework for continuing healthcare and NHS-funded nursing – describes the processes that all NHS agencies must follow when carrying out NHS continuing healthcare assessments.
Primary Health Need – this phrase is the key determination used by the Department of Health when deciding if a patient is eligible for NHS continuing healthcare. If an individual’s needs are assessed to be healthcare based, rather than social care, then they have a primary health need and should receive NHS continuing healthcare funding.
Clinical commissioning group – A clinical commissioning group brings together local GPs and experienced health professionals to undertake commissioning responsibilities for local health services; there are currently 212 CCGs in England.
NHS CHC Checklist – The NHS continuing healthcare checklist document is used to help identify people who may qualify for a full NHS continuing healthcare assessment.
Fast-track pathway tool – is the assessment tool used when a person is near the end of their life and helps to determine whether they are eligible to be fast tracked to receive NHS continuing healthcare.
Decision Support Tool – the DST is a document published by the Department of Health which helps health and social care professionals apply the National Framework for NHS continuing healthcare and helps to identify evidence of an individual’s care needs to determine if they qualify for continuing healthcare funding.
Multi-disciplinary Team – a group of health and social care specialists who work together to decide if a patient meets the primary health need criteria set out in the DST and is therefore eligible for continuing healthcare funding.
Healthcare and Social care – The two organisations responsible for providing care are the NHS and local authority (LAs) social services. Healthcare is provided by the NHS, and is free. Social and personal care is provided by local authority social services, and you may have to pay for it.
Independent Review Panel – the NHS England appeals process which consists of an independent Chair, a health professional and a social care professional (they can’t be from the same CCG who made the original funding decision). The team of three must work together to determine if the correct CHC outcome was reached in the first instance or if the patient should, in fact, be eligible for continuing healthcare.
Parliamentary & Health Service Ombudsman – the independent body established to investigate NHs England complaints; the Ombudsman has the final say in relation to continuing healthcare funding appeals.
Should you encounter any additional terms which you are unsure of, don’t hesitate to contact the Compass CHC team of continuing healthcare experts on 0121 227 8940 or contact us for a free, confidential, no obligation chat.