What is NHS Continuing Healthcare?

nurse feeding a disabled womanNHS continuing healthcare refers to a package of care that some people need to receive as a result of a disability, accident or illness. Individuals who meet the eligibility criteria will have the full cost of their care and accommodation funded by the NHS. NHS continuing healthcare is available to any UK resident over the age of 18 who is assessed as having a particularly high level of intense, complex or unpredictable health care needs. This package of care is funded solely by the NHS and is not means tested, unlike local authority funding.

To be eligible for NHS continuing healthcare individuals must first have their needs assessed by a team of health and social care professionals. A national framework for NHS continuing healthcare was developed and implemented in October 2007. The framework was designed to ensure a consistent approach to assessing individuals, as well as providing NHS trusts with a range of best practice processes and tools. The guidance set out key criteria for eligibility, namely that the care needs of the individual must be primarily health needs, rather than social or personal care needs.

Despite the introduction of the national framework, the criteria used to determine eligibility remain largely undefined, and can therefore be difficult to understand. A combination of toolkits, indicators and legal tests based upon case law are used to establish the presence of a primary health need. This lack of clearly defined criteria has created a contentious system which is open to subjectivity and individual interpretation if misapplied.

With more than 12 years’ experience navigating this system and influencing positive change within the NHS, we realise that there is still a considerable amount of confusion surrounding NHS continuing healthcare. Our clients consistently tell us that they find the process to be stressful, complex and emotionally overwhelming. At Beacon, we’re here to help you navigate this minefield. Whether you’re looking for some initial advice on the process, an honest second opinion or someone to guide you through an appeal, we can help.