How a patient qualifies for continuing health care funding
A patient should be assessed for continuing health care funding when it becomes obvious they have long-term health needs. E.g., a patient who is ill, or is about to be discharged from hospital into a care home.
Since October 2007, the NHS in England has used the National Framework to assess a patient’s eligibility for continuing health care funding; this was modified in August 2009. . The Framework recommends that the patient or carer should be involved in the assessment process wherever possible.
The Framework has three tools:
- The Fast Track Tool, used in urgent cases to obtain immediate funding.
- The Checklist, a basic screening tool that flags up any serious health needs that justify a full continuing health care funding assessment.
- The Decision Support Tool, used during a Multi-Disciplinary Assessment (MDA). This in-depth assessment looks in detail at 11 key areas of need, in terms of their nature, complexity, intensity and unpredictability. The needs are also graded in terms of their severity.
The MDA team uses the Decision Support Tool to ascertain if the patient has a Primary Health Need, in which case they are likely to qualify for continuing health care funding. However, the team should not rely on the Tool alone, but consider additional factors before making a decision.
After the assessment, the NHS Trust should write to the patient or their carer confirming whether it has awarded continuing health care funding, the reasons for its decision, and the next steps for the patient’s care. Cheselden’s Factsheet 4 tells you what happens next when funding is awarded.
If you or a relative feel that you have been wrongly denied continuing health care funding, now or in the past, please contact Cheselden so we can review your case.
