[Removed] NHS Continuum of Care Restoration (NHS CHC): Guidelines (2023)

[Removed] NHS Continuum of Care Restoration (NHS CHC): Guidelines (1)

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This publication is available at https://www.gov.uk/government/publications/reintroduction-of-nhs-continuing-healthcare/reintroduction-of-nhs-continuing-healthcare-nhs-chc-guidance


This document states:

  • such as NHS clinical trial commissioning groups (CCG) will continue SNS monitoring (CHC do NHS-a) evaluation processes from September 1, 2020
  • as it relates to the introduction of up to 6 weeks of funded health care and post-discharge recovery and support services

Department of Health and Social Welfare (DHSC) and NHS England and NHS Improvement are asking local health and social care systems to:

  • re-introduceCHC do NHS-aprocesses from September 1, 2020
  • implement (from 1 September 2020) a change in the process of fulfilling your discharge responsibilities to assess the approach in line with the Hospital Discharge Service: Policy and Operating Model (August 2020). ProvidesCHC do NHS-aand Care Act, and eligibility decisions were confirmed within 6 weeks of hospital discharge
  • takeCHC do NHS-areferrals, examinations and assessments received between 19 March and 31 August 2020 and all those postponed due to requests for discharge due to the illness of COVID-19 (March 2020).

2.restartCHC do NHS-aLegal action

The government decided so from September 1, 2020CHC do NHS-acommunity assessments, 3 and 12 month reviews and individual requests for review of eligibility decisions (local and independent review) will continue.CCGand local authorities will have to manage two parts of the job:

  • CHC do NHS-aworks postponed for the period from March 19 to August 31, 2020
  • routineCHC do NHS-areferences, from 01.09.2020

Local health and social care systems will need to establish effective processes to manage these two elements of work, which includes expanding the use of trusted assessor models and digital assessments.

Local health and social care systems should consider adapting the Law on Care and, if necessary,CHC do NHS-aassessment so that there is a single 'box' of relevant information to support a shared approach to advice (health and social care) on long-term funding by local authorities or the NHS. However, this approach should not cause further delays. It must be legal and consideredthe national framework for continuing NHS care and NHS-funded care.

The following principles should be adopted to support the collective renewal of health and social care systems.


CCGlocal authorities should provide sufficient staff to deal with the problemCHC do NHS-aand the Care Act, deferred work (from March 19 to August 31, 2020) and normal activity. This may require additional employment of health and/or social workers.[footnote 1].

Local health and social care systems must ensure efficient and effective use of the workforce through:

(Video) 26.02.2015 Joint carers' support group meeting: Continuing Health Care funding applications

  • use well-trained non-clinical staff whenever possible to free up clinical or specialist staff time to focus on good referrals for eligibility
  • providing good training programs and supervision


Good local communication with individuals and families is essential to clarify potential future long-term care funding arrangements.

To ensure effective communication and clear understanding,Standard information availableit should apply to the information and communication support needs of patients, service users, carers and parents with impairments, impairments or sensory losses.

Where care has been funded by the NHS during the Covid-19 period (from 19 March 2020), particular emphasis should be placed on explaining how the review of the Health Care Act by local authorities and the subsequent review of measures may result in some people having to contribute or fully fund their future care if they are found to be ineligibleCHC do NHS-afinancing.

Effective and efficient commands

To ensure that the right people are referred, their agreement is required.CCGand local authorities for proper useCHC do NHS-alist de controle, in accordance withnational image. versection 5: when it is not necessary to complete the NHS CHC checklistunder.

The following items must be entered:

  • official agreements to confirm who is on the "checklist" on behalf ofCCG
  • training program with checklist.

CCGcould useCHC do NHS-achecklist as part of the COVID-19 disease monitoring process for people who may need long-term care. However, another can be usedCHC do NHS-achecklist if the individual's needs decrease in the time interval between positive resultsCHC do NHS-achecklist and full assessment (see paragraph 115(2)national image). Individuals must be fully informed of this position.

warranty and management

Local assurance and governance processes will need to be put in place to ensure quality assessments are carried out and the right decisions are made regarding eligibility forCHC do NHS-a. It also includes on-site auditing and peer reviews.CCGthey must have a system for monitoring use, quality and originCHC do NHS-alist.

CHC do NHS-aEmployees who were rehired in other positions in March 2020 must be returned to their positions inCCGThe teams are expected to be operational by 1 September 2020. This process needs to be planned and carefully managed to ensure that the teams and services:CHC do NHS-awhere employees are currently working, this has no negative impact. Special caution and care must be taken when re-introducing personnel into the facilityCHC do NHS-ateams, providing employees with support throughout the process and the possibility of annual leave. Additional staff will also be required to manage the delayed work.

it will be normalCHC do NHS-aStatus report (MINOR REPORT) collection of data for implementation monitoringCHC do NHS-areviews that were deferred between March 19 and August 31, 2020. Regular data collection will begin in August 2020 and will continue until all deferred reviews are resolved.

(Video) How CHCs Are Funded - The Revenue Cycle

3.Change in discharge process to evaluate results

Hospital Discharge: Policy and Operating Model (August 2020) introduces a change to the discharge process to assess access. Effective September 1, 2020, for people who have been discharged from hospital, an assessment of a person's long-term care needs, taking into account care andCHC do NHS-aassessments should be done while the person is using funded recovery services (which can take up to 6 weeks).

CHC do NHS-aTeams should work closely with local health and social care professionals to support individuals during their discharge from hospitals 1, 2 and 3, to ensure appropriate discussions and planning of the individual's long-term care options as early as possible within 6 weeks discharge trip. This close cooperation and communication will also provide time forCCGtake everythingCHC do NHS-aassessments and local authority staff to carry out Care Act assessments where necessary.

Funding for new post-discharge care and support is intended to help people recover and rehabilitate.CCGand local authorities should implement processes to ensure that, where necessary,CHC do NHS-aand Care Act are completed and eligibility decisions confirmed by the end of the discharge process (up to 6 weeks after discharge from hospital or any "Track 2" facility).

Within 6 weeks of discharge from hospital, it is expected that an assessment of your current health and care needs will be carried out and a decision will be made by that date on how to fund this care.CCGafter the 6th week you will not be able to withdraw funds from the Discharge Support Fund to fund care packages after that date. In the rare event that a decision is not made within this timeframe, parties paying for care must continue with care until the relevant ongoing care assessments are completed. Regardless of the arrangements, the costs of the 7th week cannot be taken from the Discharge Support Fund and must be covered from existing budgets.CCGand local authorities must agree on access to care funding from week 7 onwards.

If there are local agreements about who pays for care at the time of assessment, then the local authorityCCG, if both agree and are available within the existing envelopes, may choose to continue local funding arrangements from week 7 onwards rather than follow the arrangements atthe passage below.

In the absence of a locally agreed approach to financing (see the 2 paragraphs immediately above) from week 7, the following approach is suggested by default.

Costs are allocated based on the point in the evaluation process achieved at the end of 6 weeks of care, as follows:

  • WhereCHC do NHS-aor an NHS funded nursing care (FNC) assessment has been delayed,CCGremain responsible for paymentCHC do NHS-a/FNC evaluation is complete
  • after that date if the person is found to be ineligibleCHC do NHS-a, funding will be the responsibility of local authorities, in accordance with existing procedures, until the Care Act assessment is completed, after which normal funding methods will apply

4.financial arrangements

From 19 March to 31 August 2020, the government paid for new or extended packages of care and support through the NHS for patients discharged from hospital or who would otherwise have been admitted to hospital. This approach is funded from the budget for the COVID-19 pandemic, which has been supplementedCCGand regular local authority costs for hospital discharge, rehabilitation and recovery services.

CCGit should be assumed that anyone discharged from hospital for a Route 1, 2 and 3 assessment who needed a new (or improved) package of post-discharge support or prevention would receive publicly funded careCCG, local authorities and/or Covid-19 hospital discharge funds for as long as they need (and can continue to receive) care.

(Video) Session 7 – Health System Funding Reform and the Delivery of High Quality Care

Persons who have been discharged from the hospital or who will be hospitalized in the period from March 19 to August 31, 2020.

The Covid-19 discharge and recovery budget will not be used to fund new post-discharge support packages after 1 September 2020.

Those covered by the COVID-19 Sickness Funding Agreement that began on 19 March 2020 and who took out a care package between 19 March and 31 August 2020 will continue to be funded under those agreements. Adequate assessments should be carried out for these individuals as soon as possible to ensure a transition to normal funding mechanisms.

CCGassessments are expected to be carried out in a timely manner and the speed at which delayed assessments are carried out will be regularly monitored as set out in paragraph 2 above.NHS CHC SITREP data collection.

If a person used a budget related to COVID-19 during this period and was found to be eligible forCHC do NHS-afunding, your care costs will be transferred from the COVID-19 budget to the main budgetCCGCHC calculations at the endCHC do NHS-aEvaluation process.

If a person used a budget related to COVID-19 during that time and does not meet the requirementsCHC do NHS-afunding, the cost of your care will be transferred from the COVID-19 budget to the responsibility of the local authority after the end dateCHC do NHS-aEvaluation process. Local authorities will need to determine whether individuals are still eligible for support under the Care Act or are responsible for their own care costs.

Where individuals will be assessed and determined to be eligibleCHC do NHS-aand they or the local authority funded any part of your extraordinary careCHC do NHS-aassessment thenCCGmust provide compensation directly to the individual or local authority, provided the funding is in accordance with the regulationsnational image.

CCGwill make appropriate refunds in accordance with the following rules:

  • WhereCHC do NHS-aa checklist was used, service costs from 29CCGreceiptCHC do NHS-athe checklist must be returned (see Appendix E, paragraph 9national image)
  • WhereCHC do NHS-aa checklist was used and the subject's needs had changed by the time the full assessment was completed (due to the passage of time), soCCGwill have to be repaid until the person is considered to have basic health needs
  • if not during the above periodCHC do NHS-aso a checklist was usedCCGthey will have to compensate until the person is considered to have basic health needs.

It is important that there is clarity in the new provisions on whichCCGis responsible for assessing each person's needs and paying the appropriate organization for all health services provided to that person. NHS England publishesupdated Who pays? rulesprovide that clarity.

5.When padding is not requiredCHC do NHS-alist

Circumstances in which it is not necessary to fillCHC do NHS-athe checklist is set out in paragraph 91(3).national imageThere will be many situations where it will not be necessary to complete the checklist. They belong to:

(Video) Discharge to Assess Webinar Series - Episode 1, Policy, model and pathways

  • It is clear to experts who work in the health and care system that there is no needCHC do NHS-ain this moment. If applicable, this decision and its rationale must be recorded
  • the person has short-term health needs or is recovering from a temporary condition, but has not yet reached their ideal potential
  • this is agreed byCCGthat the person should be referred directly for a full eligibility assessmentCHC do NHS-a
  • the patient's condition rapidly deteriorates and may enter the terminal phase. In these situations, a shortcut tool should be used instead of a checklist
  • the individual receives services under section 117 of the Mental Health Act that meet all of their assessed needs
  • it was previously decided that the person is not entitled to this benefitCHC do NHS-aand it is clear that there has been no change in needs
  1. Funding from the Hospital Discharge Program will be available on March 19, 2020, among othersCCG/local authorities to employ additional medical or social care staff to support the delayed assessment. More details on this additional funding and how they use it:CCGis to follow.

(Video) 154: How to apply successfully for NHS Continuing Healthcare, with Jacqueline Berry


1. Webinar: Integrating Housing into Health Care
(National Housing Conference)
2. SWL CCG Governing Body (in public) - July 2020
(NHS South West London Integrated Care System)
3. Wound assessment & management using T I M E S
4. Quality Hospital Discharge training programme
(NHS Improvement)
5. Integrated Care Webinar Series: Advancing Equity in Cancer Care for People with Mental Illness
(Northwest MHTTC)
6. CISA COVID Task Force: “Provide Medical Care is in Critical Condition” December 2021


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