The key changes are:
the NHS Continuing Healthcare Checklist; and the Decision Support Tool for NHS Continuing Healthcare (Support Tools).
NHS Continuing Healthcare (NHS CHC) is a package of care for patients aged 18 or over. It provides outside hospital care and is arranged and funded solely by the NHS. In order to receive NHS CHC funding, an individual must be assessed as having a 'primary health need'.
The National Framework practice guidance describes an individual as having a primary health need if, having taken into account all their health and social care needs, it can be said that the main aspects or majority of the care they require is focussed on addressing or preventing health needs, as opposed to social care needs. The practice guidance further states that health needs relate to the treatment, control or prevention of a disease, illness, injury or disability, and the care or aftercare of a person with these needs. There is no requirement for the tasks associated with the health needs to be carried out by a health professional. The National Framework gives four key characteristics of need (nature, intensity, complexity and unpredictability) that are key to finding the answer.
The National Framework was first published, together with a separate decision support tool document in June 2007. It set out an integrated national process to determine individuals' eligibility for NHS CHC, and became mandatory from 1 October 2007. The National Framework and Support Tools were last amended in November 2012.
To improve the operation of NHS CHC, the National Framework and Support Tools have now been updated, clarified and amended in a number of areas including:
Clearer sections explaining the meaning of 'primary health need', the roles of clinical commissioning groups and local authorities, funded nursing care, commissioning, 'topping up' care fees in specific circumstances and use of the Fast Track Pathway Tool to 'fast track' individuals with a rapidly deteriorating condition who are in need of immediate NHS continuing healthcare.
New principles that will apply when individuals challenge an eligibility decision, with the aim of resolving disputes earlier and more consistently.
Additional advice for staff in respect of the circumstances when individuals do not need to be screened for NHS CHC, to reduce unnecessary assessment processes and in response to calls for greater clarity on screening.
In conjunction with the above, on 1 March 2018 the Responsibilities and Standing Rules, and Care and Support (Miscellaneous Amendments) Regulations 2018 (SI 2018/283) (2018 Regulations) were made. The regulations amend a number of existing Regulations to reflect the updated and republished National Framework and Support Tools.
Click here to read the updated Framework and Support Tools.
We have an experienced healthcare team to assist you and your practice in dealing with changes and new developments in frameworks, and provide you with support and greater clarity on what the key changes are and how we as legal advisors be able to best assist you and meet your needs and requirements. We also have specialist litigation lawyers who will be able to go through the best options for you and your practice in relation to new and updated frameworks.