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A full assessment will be required if you are assessed with any of the following:
- Two or more domains with an ‘A’ descriptor selected
- Five or more domains with a ‘B’ descriptor selected or one ‘A’ and four ‘Bs’
- An ‘A’ descriptor selected in any of these domains: Behaviour, Breathing, Drug therapies and Medication, and Altered States of Consciousness
You do not necessarily have to meet this criteria in order to be offered a full assessment, some people may be offered an assessment with (for example) only four ‘Bs’ at the discretion of the CCG. Likewise it is not always necessary to complete a Checklist, the CCG may decide to carry out a full assessment without the need for a Checklist if they believe there is a reasonable chance that you may be eligible. Eligibility for a full assessment does not necessarily mean that you will be end up being eligible for continuing healthcare.
After a Checklist has been completed the outcome should be communicated to you (or your representative where appropriate) in writing with a rationale for how the decision was reached. If the decision is not to proceed with a full assessment the letter should contain details about how to ask the CCG to reconsider its decision.
Eligibility is based upon the presence of a primary health need which is established through an in-depth assessment process in which a multidisciplinary team fully assesses the totality of your needs. Until this detailed process has taken place nobody can unilaterally decide that you will or will not be eligible. Furthermore, unless the professional concerned has a wide range of experience within the field of continuing healthcare to draw from it is likely that their understanding of what constitutes eligibility will not be entirely accurate.
If the CCG have altered the Checklist so that you no longer qualify for a full assessment they must provide you with a written explanation about how the decision was reached so that you are able to understand exactly where the difference of opinion lies. If you disagree with the CCG, you have the right to formally request a reconsideration of the decision and then to access the NHS complaints procedure. At Beacon we have successfully challenged a number of inaccurate Checklist assessments. We are able to review your Checklist and advise you as to how it can be challenged.
Where a recommendation has been made appropriately, the CCG will work with the individual’s multidisciplinary team to arrange an urgent package of care or an appropriate placement into a care home to support the preferred choice for end of life care delivery when possible.