The National Framework

In June 2007, the Department of Health published the National Framework for Continuing Care and NHS-funded Nursing Care. This replaced all the previous guidelines for deciding who qualifies for continuing care funding.

The National Framework was introduced to:

• Set out clear criteria for establishing a Primary Health Need, to be followed by all PCTs and local authorities in England
• Clarify the relationship between NHS Continuing Healthcare and other types of care, especially nursing care
• Make the continuing care assessment process fairer and more consistent across the country and try to stop the ‘postcode lottery’
• Provide national assessment tools and common paperwork to help with decision-making and consistency, and record the reasoning behind decisions
• Prevent the need for separate assessments for different types of care, e.g. NHS-funded Nursing Care
• Clarify that the PCT and/or local authority have a duty to identify when a continuing care assessment is appropriate
• Urge the PCT and local authority to involve the patient and/or their family or carer in all stages of the assessment process.

Using The National Framework

The National Framework should be used whenever a PCT or local authority identifies that a patient might need continuing care. For example:

• If the patient has a rapidly deteriorating condition which may be terminal.
• If a patient is about to be discharged from hospital, especially if they may need to move into a care home, or are returning to a care home.
• When a patient’s care needs are being formally reviewed, usually annually.
• If the patient’s physical or mental health deteriorates and their current care package no longer meets their needs

Under the NHS Delayed Discharges (Continuing Care) Directions 2009 , any patient that is about to be discharged from hospital and may be eligible for continuing care must be assessed and a care plan and/or funding arrangement put in place before they can leave hospital. If a PCT does not follow this rule, it will have failed in its legal responsibilities.

Find Out More

The National Framework was revised in July 2009. You can download the revised Framework and supporting information at the Department of Health’s website.