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This publication is available at https://www.gov.uk/government/publications/nhs-continuing-healthcare-checklist/nhs-continuing-healthcare-checklist-guidance
What is a checklist and why is it used?
1.National Health ServiceThe Continuum of Care Checklist is a screening tool that can be used in a variety of situations to help clinicians identify those who may need a referral for a full treatment eligibility assessment.National Health Servicecontinuation of health care.
2. All employees who fill out the list must read the rulesa national framework for NHS-funded continuing health and careand also to seeA decision support tool for NHS continuing care.
3. At this stage of the process, the checklist threshold has been deliberately lowered to ensure that all persons requiring a full eligibility assessmentNational Health Servicecontinuous health care have that option.
Physicians must inform those for whom the checklist is completed that a positive checklist does not automatically lead to eligibilityNational Health Servicecontinuing care and only indicates that the person needs a full evaluationNational Health Servicecontinuation of health care.
4. After completing the checklist, there are 2 possible outcomes:
- negative checklist - meaning the person does not require and is not qualified for a full eligibility assessmentNational Health Servicecontinuation of health care
- positive checklist – meaning the person now needs a full eligibility assessmentNational Health Servicecontinuation of health care. This does not necessarily mean that the person has the right to it.National Health Servicecontinuation of health care
Observing
All of these tools are available electronically (as editable Word or ODT documents), and the pages or fields can be expanded as needed.
It should be noted that these are national tools and their content must not be changed, supplemented or reduced in any way. However, Integrated Care Boards (ICBs) can contain your logo and additional patient identification (such as adding an NHS number etc.) if required.
When to complete the checklist
5. Where there is a needNational Health Serviceaftercare, you will usually need to complete a checklist.
6. There will be many situations where it will not be necessary to complete the checklist - see paragraph 121a national framework for NHS-funded continuing health and careand "When not to use the checklist" below.
7. Review and Eligibility AssessmentNational Health Serviceaftercare should occur at the right time and place for the individual and when the individual's immediate needs are clearest.
This can happen in a variety of situations, although a full suitability assessment should usually be carried out when the person is in a social setting, preferably in their own home.
The guiding principle is that individuals should be supported to access and use the process that best suits their immediate and immediate needs. This will help practitioners correctly identify individuals who need a full eligibility assessment.National Health Servicecontinuation of health care.
8. To understand howNational Health Servicecontinuation of care includes discharge from hospital, see paragraphs 101 to 108national image.
Who can complete the checklist
9. The checklist can be completed by many health and social workers, provided they are trained in its use.
The role of the individual in the selection process
10. Give the person enough advance notice of your intention to complete the checklist and explain the procedure.
They should usually be able to actively participate in the checklist with a representative, if there is one, so that they can express their views about their needs.
11. There are many basic principlesNational Health Servicecontinuation of the healthcare process: Most importantly, assessments and reviews should always focus on the needs of the individual and follow a person-centred approach. The person must be fully informed and have the right to actively participate in the assessment process and any subsequent audit, and their opinion must be respected.
In addition, there are a number of legal requirements for a person's consent to the partiesNational Health Servicecontinuation of the health process.
12. In the spirit of a person-centred approach, practitioners should make all reasonable efforts to ensure that the person (or a person they nominate) is involved in the assessment and review process.National Health Servicecontinuation of health care in all stages of the process.
In order to make a comprehensive assessment, it is necessary to consider the best currently available evidence. This should include consideration of the person's (or their representative's) views, and that person should be enabled and assisted to participate. Throughout the process, a person-centred approach should be included in all decisions related to assessing the person's needs and planning care.
13. Consent is a legal requirement for any physical procedure or examination of a person capable of giving consent. So much so that triageNational Health Servicefollow-up care requires such an intervention or examination, informed consent must be obtained from a person capable of giving consent.
See paragraph 85national imagewhich gives detailed instructions on what is required for consent to be valid.
14. Before sharing any personal information with a third party, such as a family member, friend, lawyer and/or other representative, the express consent of the individual must be obtained.
15. However, it is not necessary to obtain the consent of a natural person to provide personal data as part of its processing.National Health Serviceongoing health assessment (and subsequent examinations) by health and social care professionals.
16. If there is concern that an individual may not be able to consent to an intervention or physical examination as part of the assessment process, or to the sharing of personal information with a third party, such as a family member, friend, lawyer and/or other representative, determine pursuant to Art.Mental Skills Act 2005and relatedcode of conduct.
A "best interests" decision may need to be made, bearing in mind the expectation that anyone potentially entitled toNational Health Servicecontinuing health care should be able to take eligibility into account. Guidelines on the application of the Mental Capacity Act of 2005 in such situations are contained in sections 86-96 of the Actnational image.
How to complete the checklist
17. Completing the checklist should be relatively quick and easy. It is not necessary to attach additional detailed evidence to the completed checklist.
18. Professionals should compare the domain descriptors with the individual's needs and choose level A, B or C as appropriate, choosing the one that best suits the individual.
If the person's needs are equal to or greater than those in column A, select 'A'.
Practitioners should briefly summarize the individual needs that support the chosen level, noting references to evidence where appropriate.
19. Full hit forNational Health ServiceContinuing medical care is required if one of the following criteria is met:
- In column A, 2 or more domains are selected
- In column B, 5 or more domains or one in A and 4 in B are selected
- the domain in column A is selected in one of the fields marked with an asterisk (indicating domains that have a priority level ofdecision support tool) with any number of selections in the remaining 2 columns
20. Very rarely there may be circumstances where a full assessment of eligibility is not possibleNational Health Servicecontinued health care is appropriate even if the person does not appear to meet the upper threshold. In these circumstances, a clear explanation must be given and local protocols must be followed.
21. Principles of "well-managed needs" (described in the section "Assessment of eligibility" in paragraphs 162-166 of the Regulationnational image) apply both to completing the checklist and todecision support tool.
What's next
22. Regardless of the outcome of the checklist - regardless of whether it relates to a full eligibility assessmentNational Health ServiceContinuity of care is considered essential – the result must be communicated clearly and in writing to the individual or their representative as soon as reasonably practicable.
This should include the reasons why the checklist result was achieved. This can usually be achieved by providing a copy of the checklist for verification.
What happens after a negative checklist
23. A negative checklist means that the person does not need and is not qualified for a full eligibility assessmentNational Health Servicecontinuation of health care.
24. If it is reasonable to expect that the person's needs will increase over the next 3 months (for example, due to an expected deterioration in their condition), this should be noted and a decision made as to whether the checklist should be revised within a specified time period.
25. If a person is verified after completing the checklist, he or she may resort to:ICBreview the result of the checklist.
OICBYou must consider this request carefully, taking into account all available information and/or including additional information from the person or guardian, although there is no obligation on the part ofICBmake a checklist to follow.
What happens after a positive checklist
26. A positive checklist means that the person needs a full eligibility assessmentNational Health Servicecontinuation of health care. This does not necessarily mean that the person will be considered eligible.National Health Servicecontinuation of health care (see paragraphs 134 to 137 sec.national image).
27. An individual should not be left without adequate support while awaiting the outcome of the assessment and decision-making process.
When not to use a checklist
There will be many situations where it will not be necessary to complete the checklist.
Before starting to complete the checklist, doctors should read the following statements to understand when it may not be appropriate to check NHS aftercare.
Situations where it is not necessary to complete the checklist include:
- It is clear to professionals working in the health and care system that there is no need for NHS continuing care at this time. If applicable, this decision and its rationale must be recorded. When in doubt between practices, use the checklist
- the person has short-term health care needs or is recovering from a temporary condition but has not yet reached their optimal potential (although a checklist may need to be completed in case of doubt among experts about the nature of the short-term needed period). See paragraphs 101 to 108national imagehow the continuation of the NHS may affect hospital discharge
- The ICB agreed that the person should be referred directly for a full eligibility assessment for NHS aftercare
- the patient's condition rapidly deteriorates and can enter the terminal phase - in such situationsquick tracking toolshould be used instead of a checklist
- a person uses services undersection 117 of the Mental Health Act 1983which meets all your estimated needs
- it has previously been decided that the person is not eligible for continuing NHS care and it is clear that the needs have not changed
If, after reviewing these statements, it is decided that confirmation of NHS continuing care is not necessary at this time, the decision not to complete the checklist and the reasons for this should be clearly stated in the patient notes.
Competent doctors should fill in the attached attachmentsNHS Checklist Reference Form– of which the original and accessible versions are available in PDF, Word and ODT format – together with these guidelines.