Once your Continuing Healthcare (CHC) assessment has taken place, the multidisciplinary team will send their recommendation whether you are eligible for funding to the Integrated Care Board (ICB). The ICB will decide whether to accept or decline your assessment results and, if upheld, the level of care and support package available to you.
The ‘National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care’ gives clear guidelines on the timescales that should be followed. It makes clear that the time between the checklist being received by the ICB and a continuing healthcare funding decision being made should not exceed 28 days.
If the timeframe is longer than this then funding should be met by the NHS whilst a decision on eligibility is met. We have heard from clients experiencing significant delays where they have been expected to pay for their care in full. This is not correct and if you are in a similar situation, do not hesitate to contact us.
When the need for care is urgent
If the need for care is more urgent, where someone is in very poor health and near the end of their life, their eligibility should be determined as quickly as possible using the Continuing Healthcare fast track pathway tool. In these circumstances, a care package should be approved and put in place as quickly as possible.
Learn more: What is a fast-track assessment for NHS Continuing Healthcare?
During their investigations, the Continuing Healthcare Alliance (a group of 13 organisations who believe NHS continuing healthcare needs to improve) discovered that the clear guidelines relating to the length of time the review process should take place were being ignored, with many people (42% of survey respondents) waiting for unacceptable time periods with little or no communication on the progress of their application.
The CHC Alliance also found that the decision on whether someone is eligible for NHS CHC funding often depends on the quality of evidence supplied and that “this varies greatly, with some assessments resulting in two lines of evidence, while others produce several pages” (page 9 ‘Continuing to Care Report).
Unfortunately we have experienced all too often ICBs and CHC teams flouting the guidelines clearly laid out in the National Framework, particularly when it comes to timescales of assessments.
Many of our clients report being told that there is a ‘backlog’ and their case decision would be delayed until the backlog has been dealt with. The CHC Alliance also raises concern that this ‘backlog’ was being blamed by ICBs for failing to meet the 28-day deadline. The Alliance discovered that in some cases the backlog could be as long as 18 months. This delay can make the process so much more challenging for families who simply do not have the time to constantly chase the NHS and ICB for information.
Unsure if you or a loved one qualifies?
If you think you or a loved one may be eligible for CHC funding, don’t delay. We’re here to guide you through every step.
Submit an enquiry to get started.
