CHC Framework

NHS Continuing Healthcare

NHS Continuing Healthcare (CHC) and NHS Funded Nursing Care (FNC) are both complex and highly sensitive areas, which can impact on some of the more vulnerable people in society and those who care for them.

Liaison Care is at the heart of supporting the NHS to standardise and improve the end-to-end delivery of CHC. This enables healthcare organisations and Integrated Care Boards (ICBs) to further access evidence-based CHC eligibility decisions.

Our integrated health and social care team provides support to NHS organisations across all areas of CHC, including fast-track, joint funding, checklist, eligibility recommendations, care needs reviews, care and support planning, inter-agency dispute resolution, 1:1 enhanced care, local resolution process and personal health budgets, NHS England independent review process preparation, and bespoke CHC consultancy.

Our approach is to ensure the management of the individual’s care pathway, with a named co-ordinator for their CHC journey with Liaison Care. There is continuous clinical and social care oversight to ensure quality and provide safeguarding assurance to an individual aged 18 or over to meet needs that have arisen as a result of disability, accident, or illness.

3 and 12 Month Reviews

The review service is designed to be provided in partnership with current teams by providing additional, skilled and focused capacity. When services are in place, individuals should expect their needs to be reviewed within 3 months to make sure that their needs are being met.

After that, care needs should be reviewed at least once a year to make sure that the service still meets the persons’ needs. The review process is clinically led, focusing on the individual’s health and support needs at all times, and ensuring that the individual and/or their chosen representative are fully engaged throughout this process.

Principles

Quality Assurance

Individual, Family and Representative Involvement

Where an individual was found to be eligible for NHS Continuing Healthcare, a review should be undertaken within three months of the eligibility decision being made. After this, further reviews should be undertaken on at least an annual basis, although some people may need more frequent reviews, this would be governed by clinical judgement and changing needs. 

These reviews should focus on whether the care plan or arrangements remain appropriate to meet the care needs of the individual. It is expected that in most cases there will be no need to reassess eligibility. 

Our consideration of quality is important to us – it defines who we are and provides confidence to our staff and our clients. We partner with the NHS to improve services, secure the best value and lever better outcomes for individuals receiving services. We drive the quality experience through:

  • Ensuring our staff receive continuous professional development
  • Ensuring the individual receives the right care through the right service with the right approach
  • Applying quality checks to everything we do, from fact-finding to engagement to evidencing

A key aspect of the Liaison Care Review process is to give the individual and their family or representative the opportunity to discuss any concerns they may have about the care being delivered and to indicate their priorities, hopes and expectations.

Decision Support Tool (DSTs)

The CHC eligibility process of the Decision Support Tool (DST) meeting is always undertaken with the individual concerned and/or their chosen representative(s) and includes the current care providers, ensuring that the individual is central to the process.

The CHC eligibility recommendations are focused on the individual’s current health needs and whether these needs meet the criteria for a Primary Health Need (PHN). This is undertaken during a co-ordinated multidisciplinary team (MDT) meeting, led by a Liaison Care health professional. The MDT will use documented and verbal evidence through the whole DST process in order to make an informed recommendation to the ICB.

CHC Local Resolution (Appeals)

When acting on behalf of an ICB to complete the above workstream, the specialist team will follow the framework and the processes used by the organisation to:

  • Review the documentation that was used in the MDT which informed the original decision
  • Consider any additional evidence provided by the individual or their representative
  • Engage with all relevant parties to coordinate the local resolution meeting
  • Hold the local resolution meeting
  • Complete an outcome recommendation report for the ICB

Liaison Care has significant experience of conducting local resolution processes in a timely manner, reducing the pressure on CHC teams and the impact of delays on individuals and their representatives. The team utilise their professional experience to assist individuals who appeal eligibility decisions with equity and openness.

Quality Reviews

Liaison Care work collaboratively with organisations and their local authority partners in the Integrated Care System (ICS) to identify good practice and distinguish where there might be concerns or areas for improvement, before agreeing subsequent remedial actions.

Liaison Care can host useful feedback sessions to help improve future processes and further enhance evidenced practice for CHC teams.

Retrospective Reviews

Our appeals team can also conduct retrospective casework, utilising our well-established internal processes for efficient outcomes which meet the goals of the organisation, whilst always working in the best interest of the individual and their chosen representatives.

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