NHS Continuing Healthcare Funding (CHC Funding) lawyers

The costs of privately funding health and social care can be prohibitive. However, funding for the provision of health and social care is available through the NHS for certain patients, via the Continuing Healthcare Funding (CHC Funding) route.
 

We can assist with NHS Continuing Healthcare Funding applications and appeals. Establishing whether or not you or a family member is eligible is critically important as funding is available if it is determined that there is a primary health need.  Without funding, this care would otherwise have to be met by the individual or their relatives.

Our regulatory team works closely with independent specialist nurses who are experts in assessing patients for funding, meaning that we can swiftly and accurately advise on eligibility and thus prospects of success.

We are independently ranked as specialists in healthcare regulation, having acted in the field for several decades. We act for individuals, regulators, organisations and corporates, making our insight into the sector unparalleled.

From assisting with initial applications, to advocating your case on appeal, we can provide you with the assistance you need to navigate the process.  

The process 

Funding is only available following assessment.

The CHC Assessment has two stages. The case will only progress to the second stage if the first is successful:

  • A Checklist Assessment;  and
  • A Full Assessment.

 

Checklist Assessment

The person who fills in the Checklist Assessment should preferably be familiar with your specific needs (i.e. a GP or nurse) as well as the principles of the National Framework for Continuing Healthcare and NHS-funded Nursing Care.

The Checklist is a screening document that identifies whether a full assessment is required. There are 12 domains subdivided into statements of need; these domains are similar to the full assessment, but not as in-depth. The domains are allocated scores of A, B or C - A being the most severe. The trigger for a case to be referred for full assessment is when two needs are scored as an A or one as an A with four B’s or five B’s. However, there are domains which are referred to as asterix domains; should an A be scored in any of these particular domains the case would automatically be triggered for a full assessment regardless of any other scores.

The person completing the Checklist will compare the domain descriptors to the needs of the individual and select whichever most closely matches the individual. There are two potential outcomes following completion of the Checklist Assessment:

  • A negative Checklist, meaning the individual does not require a full assessment; or
  • A positive Checklist meaning an individual requires a Full Assessment.

 

Full Assessment 

Full Assessments for NHS Continuing Healthcare are undertaken by a minimum of two professionals from different disciplines (usually a Nurse Assessor and a Social Worker). 

The assessment will consider your needs under the same 12 domains as the Checklist Assessment.

If you have at least one priority need, or severe needs in at least two areas, you can usually expect to be eligible for NHS Continuing Healthcare.

 

Urgent needs – Fast Track Assessment

There are cases which require a Fast Track Assessment, when an individual’s health is rapidly deteriorating.

In Fast Track cases an ‘appropriate clinician’ will initially determine if the individual has a primary health need. In such cases, the Clinical Commissioning Group is required to respond promptly and positively to ensure that the appropriate funding and care arrangements are in place without delay.

The appropriate clinician will complete the fast-track documentation setting out how their knowledge of the patient’s needs, leads them to conclude that the patient has a rapidly deteriorating condition and that the condition may unfortunately be entering a terminal phase.

 

How can we help with your CHC funding application?

Depending on your needs, our service may include:

  • Obtaining relevant medical records;
  • Instruction of a nursing expert to attend the initial/full assessment to support you;
  • Reviewing the decision of a negative assessment and advising you as to the merits for challenge;
  • Instructing a nursing expert to undertake an independent assessment;
  • Collation and submission of your documents for an application or appeal; and
  • Presenting your case before the panel.

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