NHS Continuing Healthcare and hospital discharge – the assessment game: Part 3

Please note: This article was published prior to January 2024, and some information may be outdated.

NHS Continuing Healthcare funding assessments and discharge from hospital

Is the hospital discharge team forcing your relative out?

These tips follow on from Sarah’s case study about her mum, and the attempts by the hospital discharge team to discharge her mum without the proper NHS Continuing Healthcare funding assessments.

Part 2 highlights some initial vital tips.

Here in Part 3 we’ve included further vital tips to help you if you’re in a similar position…

If you’re under pressure to get a relative out of hospital, you may be asked to sign hospital discharge forms or other forms. Be careful what you sign – here’s why.

No one can have made a decision about Continuing Healthcare funding unless there has been an initial Checklist assessment and, if your relative passed this, a comprehensive multidisciplinary team (MDT) Continuing Healthcare assessment. This should involve you and include input from you and from every relevant physician, therapist, carer, nurse, etc. A Decision Support Tool (DST) form is completed at the MDT meeting. (Note: This is not the same as a Best Interests meeting.)

The Checklist and the MDT assessment meetings can be replaced by the Continuing Healthcare Fast Track process if a) your relative is in a period of rapid deterioration OR b) they are at end of life. Fast Track funding is put in place immediately, without any long discussions or arguments.

If you’re simply told that a Continuing Healthcare assessment has already been carried out, and yet you have not been involved or allowed to input, it means the process is flawed.

If the health and social care authorities have acted wrongly in any of these ways, your relative should not be discharged until they do things properly.

You’ll find the different stages of the NHS Continuing Healthcare assessment process here.

You should be given a copy of all assessment notes, e.g. the Checklist and the Decision Support Tool. If the NHS is unable to provide this, and you weren’t involved in the Continuing Healthcare assessment meetings, it could mean they haven’t actually done any proper assessments at all.

There is something called Joint Funding where the NHS and the local authority (LA) share funding responsibility, and the CHC guidelines make reference to this, BUT… in many people’s experience this can sometimes seem to be a way for the NHS to avoid full funding.

Also, if a person’s care needs are either above or below the line between NHS and local authority care, it’s always worth challenging any suggestion of ‘joint’ funding.

Go back to the Continuing Healthcare tips in Part 2

Read the original case study about hospital discharge and NHS Continuing Healthcare

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2 Comments

2 responses to “NHS Continuing Healthcare and hospital discharge – the assessment game: Part 3”

Richard says:

20 September 2016 at 06:30

Been trying to get mum in law out of hospital since May when “medically fit”. Last Continuing Healthcare (CHC) April. At yesterdays meeting with local authority (LA) lawyers, mother in law’s lawyers and NHS lawyer they insist as she needs 24 hour nursing care, but NHS have refused to entertain our request for a fresh CHC. From a DPA the LA in internal notes are clear her needs are beyond the legal limit; her needs have greatly changed. The LA want her in a nursing home. She has capacity and does not want to go. They keep going back to her with ‘if you go home it will only be 4 visits a day, you know you can’t cope’. Who is responsible for actually initiating a Decision Support Tool for CHC. LA say not them, NHS not us…….

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- Angela Sherman says:
  
  23 September 2016 at 11:54
  
  Richard – this kind of buck passing is sadly not unusual. We hear many accounts from families of such behaviour. If your mother in law’s needs are beyond the local authority legal (LA) limit then the NHS MUST fund her, in law. If she would be safe at home, and she has the capacity to make that specific decision, there seems little reason for her not to be there. The pressure on her to be in a nursing home could be motivated by budgets. Write to the Head of Adult Care at the LA and also to the Head of Continuing Healthcare at the CCG and outline that both are acting illegally a) if your mother in law continues to be an LA responsibility and b) if the CCG fails to complete the proper Continuing Healthcare assessment process. A social worker must (under the Care Act) refer a person for Continuing Healthcare if there is any indication the person might be eligible. This may also help: http://caretobedifferent.co.uk/care-act-2014-helps-you-with-nhs-continuing-healthcare/ and also this article: http://caretobedifferent.co.uk/paying-for-care-between-hospital-discharge-and-funding-decision/.
  
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