Continuing Health Care (CHC) Some people with long-term complex health needs qualify for free health and social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare. NHS continuing healthcare is for adults. Children and young people may receive a “continuing care package” if they have needs arising from disability, accident or illness that cannot be met by existing universal or specialist services alone.
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Fee amounts correct as of April 2023. Fees are reviewed on a yearly basis and are subject to change.
These fees cover our costs to:
• Buy care and support services on your behalf • Raise invoices to recharge you and collecting payment • Manage your accounts • Arrange quality assurance checks of care providers When a relative or friend is paying your extra care home costs
To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a multidisciplinary team).
Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS continuing healthcare may change. You should be fully involved in the assessment process and kept informed and have your views about your needs and support taken into account. Carers and family members should also be consulted where appropriate. If you are not eligible for NHS continuing healthcare, you can be referred to your local council who can discuss with you whether you may be eligible for support from them.
If the result of your financial assessment is that you qualify for the council to pay your care home fees, you will only receive funds up to a maximum set amount, known as usual cost. Usual cost is the standard amount expected by a care home that can meet your care needs to charge, and we must be able to show that there is at least 1 suitable care home available at this usual cost. If you choose a care home above usual cost Any extra costs, above usual cost, is referred to as either top-ups or additional payments. Who pays top-ups You must ask a relative, such as a son or daughter, or friend, to pay any costs above usual cost if you: • Choose a care home that charges more than your allowance • Decide on more expensive accommodation within a care home with usual cost accommodation If the council are unable to find you a suitable placement at a care home within usual cost and as a result, they arrange to place you in more expensive accommodation out of necessity rather than preference, you will not be asked to pay the top-up costs. What someone making top-up payments should know
www.beaconchc.co.uk
www.gov.uk/government/publications/nhs-continuing-healthcare
Initial assessment for NHS continuing healthcare The initial checklist assessment can be completed by a nurse, doctor, other healthcare professional or social worker. You should be told that you’re being assessed and what the assessment involves. Depending on the outcome of the checklist, you’ll either be told that you do not meet the criteria for a full assessment of NHS continuing healthcare and are therefore not eligible, or you’ll be referred for a full assessment of eligibility. Being referred for a full assessment does not necessarily mean you’ll be eligible for NHS continuing healthcare. The purpose of the checklist is to enable anyone who might be eligible to have the opportunity for a full assessment.
The person making the top-up payment on your behalf must understand that:
The professional(s) completing the checklist should record in writing the reasons for their decision, and sign and date it. You should be given a copy of the completed checklist.
• The amount they must pay could go up if the care home reviews its charges • Your funding assistance payments will be regularly reviewed and may change- this could make a difference to the amount they must pay payment top-ups will be required for as long as you stay in that care home, and this could be a number of years • If the payment is not made, or if circumstances change for the person paying and they can no longer afford to pay, you must move to accommodation that charges no more than usual cost
Full assessments for NHS continuing healthcare are undertaken by a multidisciplinary team (MDT) made up of a minimum of 2 professionals from different healthcare professions. The MDT should usually include both health and social care professionals who are already involved in your care.
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