NHS Continuing Healthcare

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Has anyone applied for this and if so what was your experience?

Looking at lots of options for Mum and found this

thank you very much

Is that the one where you get a funded place in a home?

Yes it is

(copy and pasted this)

Some people with long-term complex health needs qualify for free social care arranged and funded solely by the NHS. This is known as NHS continuing healthcare.

Ok so I believe that it's incredibly hard to access but some people do obviously get it. DFIL has it at the moment due to inoperable cancer and recurrent infections. DMIL who has advanced Vascular Dementia and Delirium doesn't qualify.

DF bedridden, dementia, a heart condition, skin breakdown doesn’t qualify.

See if you can find the CHC “Decision tool” on the internet (not the short screening questionnaire) It’s an eye opener as to how ill people can be. That said, applying was straightforward and once you’ve been turned down they automatically reassess every 12 months.

CHC decision tool downloadable from here.

I’ve been involved in lots of these assessments and also used to have a role challenging the nhs about people that didn’t get it but should have in our opinion (local authority).

First thing is not to get your hopes up, it is hard to qualify for and only really if someone’s care needs are very intense and not routine.

it doesn’t have to be in a care home the nhs can in theory fund care in your own home too (although these days cost will be a big consideration so unlikely to get care at home if it’s a lot more expensive than a care home)

look at the NHS continuing care checklist online, that’s the first step of the assessment and see if you think your parent would ‘score’ enough to trigger for full assessment.

it doesn’t hurt to apply but it’s a ridiculous system and lots of people you would think would get it, don’t.

This gives you an overview:

www.nhs.uk/conditions/social-care-and-support-guide/money-work-and-benefits/nhs-continuing-healthcare/

In my experience, 2016ish with a relative with Parkinson’s, we were told they weren’t eligible by the hospital, and also by a follow up checklist by the district nurse.

We then appealed to the local Clinical Commissioning Group, who allowed the claim and ruled that he was eligible.

It helped that we had another family member’s diary, that had recorded all the falls, and ambulance call-outs, and various other factors that showed there were needs across several areas of the checklist.

I’d advise getting familiar with the Framework document and the Decision Making Tool (it’s like a worksheet) and to appeal with all the facts you can gather if you think they haven’t got it right initially. Also keep monitoring yourself, in case your Mum’s condition changes.

www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-nhs-funded-nursing-care

My mother got it because of her behaviour and specialist needs (she tried to strangle a nurse and blocked the drains in the nursing home). The CHC assessing nurse was amazing and it felt like she was the first person who actually understood my mum's condition.

Yes we got this for my mum who had terminal bowel cancer, copd and Crohn’s disease. She owned her own home outright but needed a place in a hospice / nursing home quicker than she could sell the house to pay for care so she was assessed and was given a fully funded place in a nursing home where she was cared for until she died. It was quite straightforward to do. Only took a week or so all in all. (She died 8 weeks after she was diagnosed with bowel cancer, it was diagnosed when it was very advanced).

Thank you for all of your replies. Mum currently in hospital for the past week. Wating for a scan for dementia but since she has been in she is much worse. She was mobile before the illness where she had low potassium and sodium and now is unable to stand let alone walk. Dad has physical needs and his cognition is also declining to a point where it to is quite bad.

So if mum does not pick up she has both mental and physical needs. I will explore the links notes further. Thank you very much

I have been intouch with Adult Care Services who were really kind and helpful but are waiting on the hospital discharge team who in turn are waiting on the clinical team. It saddens me to say that she is not coming out anytime soon.

Thank you again

Unfortunately with what you describe it is unlikely your mum will get funded care. I've seen clients who are registered blind, unable to walk and with advanced dementia who are having to self-fund.

Its incredibly difficult to get its for complex needs only, if she doesnt qualify you can apply for fnc which is a nursing contribution paid to the home

Yes, on that description I don't think she'd qualify. It's for complex needs rather than severe needs, if that makes sense. Very very sick people are, ironically, quite straight forward to manage so don't tend to qualify. Try and argue your case around the decision tool for the best chance at getting it.

She may be eligible for an element of funded nursing care, but sounds unlikely for CHC.

Thank you. I will give it a go after work/hospital etc. It seems from your experience that it won't happen. That said it may lead to more learning on my part which may in turn push me down other pathways.

thank you

I would agree that unfortunately people with dementia rarely get CHC funding. The basic difference is when the care you need tips over from being normal “social care” into something more specifically complex and health related. That is why people with cancer/terminal illnesses will often find it easier to get.

It is very very difficult to get but you can at least try. Read all of the paper work and guidance thoroughly and be prepared to give examples.

Thank you. Mum continues to deteriorate in Hospital so even discussing with the Discharge team is on hold. I will look into everything as it gives me a purpose and stops me worryingfor a short-while about mum and dad.

thank you

Was that the fast track route? The fast tracking is possible because they don’t do such a rigorous assessment (which is why people who have “lived too long “ can be transferred to the usual route and then found to be ineligible and have funding withdrawn)

It seems a postcode lottery sadly. We got it for my Uncle with vascular dementia which caused falls and challenging behaviour.

I got it (3rd attempt) for FIL (Heart failure) The deciding factor was that he had loads of other minor issues requiring frequent medical (not carer) attention.

I advise getting a local authority care needs assessment, ask for a social worker for your mum then go for CHC assessment. The social worker should advocate for you.

Have you applied for everything your mum & dad are entitled to receive?

-attendance allowance for both of them,
www.gov.uk/attendance-allowance

-council tax reductions for a disabled person?
www.gov.uk/council-tax/discounts-for-disabled-people

—means tested benefits (pension credit, council tax benefit)