CHC review support increases efficiencies across ICB

The Challenge

Over recent years, NHS Devon ICB had developed an increasing backlog of overdue Continuing Healthcare (CHC) 3-month and 12-month reviews, Multi-Disciplinary Team Decision Support Tool reviews, and Fast Track reviews.

Where these reviews are not completed in a timely manner, there is a risk that the individuals may be receiving packages of care which either do not meet their needs or are inappropriate in size. In addition to this, funding may be disproportionately spent in areas where it may not be required and could be better used elsewhere or for other individuals in need.

Regional financial pressures were continuing to have an impact, so the ICB turned to Liaison Care for a solution, as our team was supporting Trusts in the region at the time.

The Solution

Liaison Care was contracted to clinically review the backlog of over 350 CHC cases and ensure that the care being provided was proportionate to the needs of individuals, and that the funding for this care was provided via the appropriate source.

Liaison Care firstly agreed with the ICB the rate at which the reviews would be conducted. This was to ensure that the local CHC team was not overwhelmed and able to provide appropriate clinical verification to each of the cases undertaken.

Each individual’s case followed the same process for review and quality assurance to ensure the same exacting standards were maintained. These reviews were person centred, clinically focused, and with all representatives and providers of care invited to take part. Once completed, the documentation and outcome of each review was verified by the ICB.

The majority of cases ended their process at this stage. However, where appropriate and where a significant change in clinical need was identified, Liaison Care undertook a Multi-disciplinary Team Meeting (MDT) where eligibility for CHC would be assessed. The same attendees were invited to this meeting along with the addition of Social Care representatives. To support and prepare for the MDT, additional evidence was requested, which would be used to substantiate any needs identified.

As with the review documentation, all MDT documentation and evidence was provided to the ICB to enable full clinical verification of the recommended outcome from the MDT.