The first step is to have a screening tool completed with a health or social care professional (a checklist). Health and social care staff use the checklist to help judge whether a full assessment for NHS Continuing Healthcare should happen.
The second step is a full assessment of eligibility. This involves a multi-disciplinary team applying the ‘Decision Support Tool’. The tool will be completed by health and social care professionals. This looks at twelve different types of need, for example, mobility, nutrition, and behaviour. The tool helps decide on the nature, complexity, intensity and unpredictability of your needs known as a ‘primary health need’.
This is likely to be a complex medical condition that requires substantial ongoing healthcare. Eligibility is not dependent on a particular diagnosis or disease, or determined by the location of where your care is provided. If your assessment does not identify a primary health need, you will not be eligible for NHS continuing healthcare.
We follow national guidance and criteria in assessing your care needs and eligibility. You will be fully informed and involved throughout this process. If you wish, you can ask a member of your family, a friend, a carer or perhaps another representative, to support you during this assessment process. We encourage you to do this.
In some cases, an urgent decision is needed, for example those who are terminally ill, and this can be assessed via use of the fast Track Tool to provide timely NHS continuing healthcare for those rapidly deteriorating and entering a terminal phase.
Your health needs are assessed by looking at all of your care needs and relating them to four indicators:
• Nature – the type of condition or treatment required.
• Complexity – symptoms that interact; therefore difficult to manage or control.
• Intensity – one or more health needs, so severe they require regular intervention.
• Unpredictability – unexpected changes in condition that are difficult to manage and present a risk to the person or others.
If you are eligible, NHS Cambridgeshire & Peterborough will be responsible for identifying and funding a package of care that has been discussed and agreed with you and your family or representative. Funding is subject to regular review and if your healthcare needs change, the funding arrangements may also change. As this is a health funded service it is not dependent on savings or income.