Some people with long-term complex health needs qualify for free health and social care arranged and funded by the NHS, the Local Authority and sometimes by a third party. This funding is known as NHS continuing healthcare and is arranged/commissioned by the personalised commissioning department at our CCG.
In our area, children, young people and adults and can be given funding for continuing healthcare which can be provided in a variety of settings outside hospital, such as in a person’s own home or in a care home.
To be eligible for continuing healthcare funding, a person must be assessed by health and social care professionals. A decision about funding should usually be made within 28 days.
You can find out more about continuing healthcare on the government website (opens in a new window).
Personal health budgets
A personal health budget is an amount of money to support someone’s health and wellbeing needs, which is planned and agreed between the individual or their representative, and our CCG. It isn’t new money, but a different way of spending health funding to meet the needs of an individual.
Personal health budgets are a way of personalising care, based around what matters to people and their individual strengths and needs. They give disabled people and people with long term conditions more choice, control and flexibility over their healthcare.
A personal health budget may be used for a range of things to meet agreed health and wellbeing outcomes. This can include therapies, personal care and equipment. There are some restrictions in how the budget can be spent.
You can read more about personal health budgets, including frequently asked questions on the NHS England website (opens in a new window).
Contacting the personalised commissioning team
- email: email@example.com
- phone: 01274 423003
- write to: Personalised commissioning department, NHS Bradford District and Craven CCG, Scorex House, 1, Bolton Road, Bradford, West Yorkshire, BD1 4AS
Continuing healthcare assessments during the coronavirus pandemic
Some people with long-term complex health needs qualify for care arranged and funded solely by the NHS. This is known as NHS continuing healthcare.
How continuing healthcare assessments are working during the coronavirus pandemic
Across England, NHS continuing healthcare assessments were put on hold between 19 March and 31 August 2020 to help the NHS respond to the coronavirus pandemic. This was a national decision made under the Government COVID-19 Hospital Discharge Service Requirements guidance. Throughout this period our Personalised Commissioning Team continued to receive referrals for assessments.
Nationally, NHS continuing healthcare assessments started again on 1 September 2020. Because we continued to receive referrals for assessment during the pause, there is currently a backlog of cases which need to be reviewed. Our team is working extremely hard to assess each case, with the most clinically urgent cases being managed first.
We understand that this will be a difficult time for patients, families and carers who are waiting for their cases to be assessed, but please be reassured that we are working hard to manage all cases, and our team will be in touch.
While continuing healthcare assessments were paused between 19 March and 31 August 2020, the government paid for new packages of care, or extensions of existing packages of care and support for patients discharged from hospital, or for those patients who would otherwise have been admitted to hospital. This was paid for through a government COVID-19 budget known as the COVID-19 discharge and recovery service budget.
From 1 September 2020, the COVID-19 discharge and recovery service budget will not be used to fund any new package of support.
If you are a patient who was funded using the COVID-19 discharge and recovery service budget, and started a care package between 19 March and 31 August 2020, you will continue to be funded through those arrangements. Our CCG are working towards assessing these packages of care to see if they are eligible for transition to normal continuing healthcare funding arrangements. In the meantime you will continue to have your care paid for through COVID-19 funding arrangements until further assessments can take place.
If you have been funded using the COVID-19 discharge and recovery service budget, and following an assessment, are found to be eligible for continuing healthcare funding, the payment of your care costs will automatically transfer to our organisation.
If following an assessment, you are not eligible for continuing healthcare funding, the payment of your care costs will transfer to the local authority (Bradford Council or North Yorkshire County Council), following the end date of the continuing healthcare assessment process. The relevant local authority will then need to assess if you continue to be eligible for support under the Care Act and subsequent means testing. This could mean that you may have to contribute to or fully fund your future care. The Covid-19 funding you are receiving will continue to be paid until you have had your assessment and the Local Authority has taken over your care package.
Further information about this can be found on the relevant local authority website:
To be eligible for NHS continuing healthcare, you must be assessed by a team of health and social care professionals (known as a multidisciplinary team). The team will look at all your care needs and relate them to:
- what help you need
- how complex your needs are
- how intense your needs can be
- how unpredictable they are, including any risks to your health if the right care isn’t provided at the right time
Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition. If your needs change then your eligibility for NHS continuing healthcare may change.
We will keep you fully involved and informed throughout the assessment process. Your views about your needs and support will be taken into account. Carers and family members will also be consulted as appropriate.
A decision about eligibility for a full assessment for NHS continuing healthcare should usually be made within 28 days of an initial assessment or request for a full assessment.
If you aren’t eligible for NHS continuing healthcare, you can be referred to your local council (either Bradford Council or North Yorkshire County Council) who can discuss with you whether you may be eligible for support from them.
If you still have some unmet health needs not supported through community services, then the NHS may pay for part of the package of support. This is sometimes known as a ‘joint package of care’.
From 1 September 2020 there has been a change of process for those people being discharged from hospital. An assessment of the person’s longer-term care needs, including Care Act and NHS continuing healthcare assessments, should be undertaken during the period of funded recovery services (which can be up to a maximum of six weeks). This is called the ‘discharge to assess’ pathway.
Our personalised commissioning team will work closely with health and social care staff at the relevant local authority (council) to ensure appropriate discussion and planning for long-term care happens as early as possible after discharge (within six weeks). This discussion and planning should allow for our CCG to undertake a full continuing healthcare assessment and for the council to undertake Care Act assessments as needed. A decision about how a person’s long-term care will be funded should happen within six weeks of discharge. If the assessment hasn’t been completed within 6 weeks your funding will remain in place.
The funding of care and support on discharge from hospital is intended to support people to recover and rehabilitate.
If your health, or the health of somebody you care for, is deteriorating, please contact your GP, community practitioner social worker or current care provider to make sure your healthcare needs are met whilst you wait for your assessment.
We normally aim to make a decision about eligibility for a full assessment for NHS continuing healthcare within 28 days from the day we receive your referral. At the moment, while we continue to respond to the coronavirus pandemic, assessments may take a little longer than usual. You will receive the outcome of your assessment in writing after this.
While you wait for your assessment, if you have any questions, please contact the CCG personalised commissioning team by email at C.firstname.lastname@example.org or by calling 01274 423003.
Yes you can appeal an assessment or request an assessment of previous unassessed periods of care. However, due to the backlog of assessments during the height of the coronavirus pandemic, we are unable to resume appeals and retrospective assessments at this time.
We will write to you when your case is allocated to a nurse or there is further progression through the appeals process. Unfortunately, we are currently unable to provide you with timescales for completion of your appeal / request for retrospective assessment.
We appreciate this may be inconvenient and thank you for your understanding and patience during this time.
Funding / reimbursement for any NHS continuing healthcare eligibility identified can be backdated accordingly. You will not be financially disadvantaged due to the continued delay in the resumption of appeals / retrospective assessments.
If after speaking to our personalised commissioning department, you still wish to raise a an appeal, concern or a complaint, you can contact our CCG patient support line.