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Changes to COVID-19 Continuing Healthcare funding- November 2020

Thu 19th November 2020

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During the first phase of the COVID-19 pandemic the government agreed that under temporary COVID-19 legislation all care that facilitated hospital discharge or prevented admission to hospital would be paid for by the NHS. This was part of a range of policies designed to protect the NHS so that we could deal with the pandemic.

This temporary funding is now coming to a close in line with the legislation. Anyone who had received fully funded care, will now be assessed as part of the pre-COVID arrangements for Continuing Healthcare.

To ensure that your on-going care needs are met and funded appropriately we will be contacting you soon to complete an assessment. Your current placement / care package will continue to be funded until your assessment is completed and you will be notified in writing of any changes.

The outcome of your assessment may be:

  • You are funded via Continuing Healthcare
  • A portion of your care in a care home may be funded via a funded nursing care contribution with additional support from the local authority
  • A portion of your care in a care home may be funded via a funded nursing care contribution and you may be self-funding the remainder
  • You are not eligible for on-going funding through Continuing Healthcare but may be entitled to support via the local authority. If, this is the case we will arrange for the local authority to undertake a financial assessment, to see if you are eligible for funding support.

How will we assess safely?

To maintain social distancing and reduce the risk of infection the multi-disciplinary team will, with your consent, use your clinical or social care records to build up a picture of your needs. You and your nominated representatives will be invited to contribute in different ways if you cannot attend the assessment. This will be completed by a phone call or Microsoft Teams meeting. More information and a user guide for Microsoft Teams is available and will be explained when arranging your appointment.

 

People whose CHC funding commenced after 31 August 2020

How is long term care funded in England?

  • NHS Continuing Healthcare (NHS CHC) means a package of ongoing care that is arranged and funded solely by the National Health Service (NHS) specifically for the relatively small number of individuals (with high levels of need) who are found to have a ‘primary health need’ which means that their care needs have been assessed as very complex.
  • NHS CHC is provided to an individual aged 18 or over to meet health and associated social care needs that have arisen as a result of disability, accident or illness. It is the responsibility of the Clinical Commissioning Group (CCG) to determine and fund the appropriate package of support for someone who is eligible for NHS CHC.
  • Social care support provided by local authorities may involve the individual making a financial contribution depending on income and savings. If the local authority is involved in funding some of your care package then, depending upon your income and savings, you may have to pay them a contribution towards the costs of that part of your care package.
  • Whether or not you are eligible for NHS CHC, you are still entitled to make use of all of the other services from the NHS in your area in the same way as any other NHS patient.
  • If you are eligible for NHS CHC, your CCG will be responsible for your care planning, commissioning services and your case management. The CCG will discuss options with you as to how your care and support needs will be best provided for and managed.
  • ‘NHS-funded nursing care’ is a standard rate contribution by the NHS towards the cost of providing registered nursing care for those individuals who are determined to be eligible by the CCG and are in a care home with nursing.

What are the next steps for my on-going care?

  • The Government has agreed to provide additional funding to help cover the cost of post-hospital discharge recovery, support services, rehabilitation and reablement care in addition to what was provided prior to admission to hospital, for up to a maximum of six weeks following discharge from hospital.
  • Whilst this funding is covering all or some of your needs at the moment, this is not NHS Continuing Healthcare and does not mean that you are eligible to NHS Continuing Healthcare to meet your long term care needs.
  • If your NHS CHC assessment determines that you are not eligible for NHS CHC, the CCG will then determine whether you are eligible for ‘NHS-funded nursing care’ and can also refer you to your local authority who can discuss with you whether you may be eligible for support from them.

 

People whose CHC funding commenced 19 March 2020 – 31 August 2020

How is long term care funded in England?

  • NHS Continuing Healthcare (NHS CHC) means a package of ongoing care that is arranged and funded solely by the National Health Service (NHS) specifically for the relatively small number of individuals (with high levels of need) who are found to have a ‘primary health need’, which means that their care needs have been assessed as very complex.
  • NHS CHC is provided to an individual aged 18 or over to meet health and associated social care needs that have arisen as a result of disability, accident or illness. It is the responsibility of the Clinical Commissioning Group (CCG) to determine and fund the appropriate package of support for someone who is eligible for NHS CHC.
  • Social care support provided by local authorities may involve the individual making a financial contribution depending on income and savings. If the local authority is involved in funding some of your care package then, depending upon your income and savings, you may have to pay them a contribution towards the costs of that part of your care package.
  • Whether or not you are eligible for NHS CHC, you are still entitled to make use of all of the other services from the NHS in your area in the same way as any other NHS patient.
  • If you are eligible for NHS CHC, your CCG will be responsible for your care planning, commissioning services and your case management. The CCG will discuss options with you as to how your care and support needs will be best provided for and managed.
  • ‘NHS-funded nursing care’ is a standard rate contribution by the NHS towards the cost of providing registered nursing care for those individuals who are determined to be eligible by the CCG and are in a care home with nursing.

What are the next steps for my on-going care?

  • NHS CHC assessments were suspended during the period from 19 March 2020 to 31 August 2020 to create and maintain sufficient capacity in hospitals to deal with the Covid-19 emergency. The Government agreed to fully fund the cost of new or extended out-of-hospital health and social care support packages for people being discharged from hospital or who would otherwise be admitted into it.
  • Whilst this funding is covering all or some of your needs at the moment, this is not NHS Continuing Healthcare and does not mean that you are eligible to NHS Continuing Healthcare to meet your long term care needs. From 1 September 2020, the Government has decided that NHS CHC assessments will recommence.
  • If your NHS CHC assessment determines that you are not eligible for NHS CHC, the CCG will then determine whether you are eligible for ‘NHS-funded nursing care’ and can also refer you to your local authority who can discuss with you whether you may be eligible for support from them.

 

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