Continuing Health Care:Entitlement to NHS eligibility assessment
(National Framework Guidance for NHS Continuing Healthcare and NHS-funded Nursing Care in England October 2007) Revised July 2009 implemented October 2009.
Current Eligibility:
Just Care Consultancy Ltd can offer specialist knowledge and experience when considering whether you are entitled to an NHS assessment to determine if you or your relative may meet fully funded NHS eligibilty criteria, which would then determine that the NHS would be fully responsible for funding in the appropriate care setting to meet your needs. Your health care needs are considered against the above framework. By engaging in our services we can help to complete an initial assessment to assess your case to determine if you or your relative should be considered.
Although there is one National Framework Guidance and the aim of this was to eliminate a post code lottery, it is our experience that each Primary Care Trust has interpreted this guidance differently and therefore outcomes of eligibilty are not consistent. So, even if you do not live in Sussex Just Care Consultancy Ltd can evaluate your case to consider if you should proceed with obtaining an assessment.
If you are the client, relative, or advocate and in receipt of the old High Banding Funded Nursing Care Award and you are residing in a nursing home please ring Just Care Consultancy Ltd for your free 15 minute consultation. Many individuals who met this High Band Award of funding prior to Oct 2007 now meet NHS eligibilty for Continuing Healthcare especially if your needs are complex, intense, unpredictable or beyond the legal limit of Local Authority provision of care. So , if you have not been re-assessed please contact Just Care Consultancy Ltd .
If you are found to meet the criteria then from the assessment date of the Decision Support Tool (DST) you will be entitled to your care fees to be fully paid. Potentially this could save thousands of pounds. It must be highlighted that if you meet this eligibilty criteria it is subject to review and funding is not guaranteed for life.
Continuing Healthcare is a complex system to navigate through but by engaging Just Care Consultancy Ltd we can help and give informative guidance and written support. Please call our free 15 minute consultation so we can determine whether in our experience you should proceed. If at the end of this free telephone consultation the recomendation supports that you have a case, on your verbal agreement we will send a letter of confirmation,details of fees and a contract prior to any further work being undertaken.
The Department of Health have implemented a revision to the original Guidance and this revision was from October 2009.
The NHS Continuing Healthcare checklist helps to identify people who need a full assessment for NHS continuing healthcare. Is is based on the decision support tool and those that are completing this should be trained and reflect the principles of the decision support tool.A full assessment should be completed if: 2 or more domains selected in the A column, five or more selected in the B column, or one in A and 4 in B, or one or more marked with an asterix in the A column.
Decision Support Tool:
This is a multidisciplinary tool completed by those who knows the clients needs the best. Capacity must be assessed and considered and the over riding principle is to be inclusive of the primary carers views and experiences so that the assessment is relevent and transparent and inclusive.
It is clear that this process to determine eligibility is complex and varied.
One telephone call to Just Care Consultancy Ltd could potentially save you thousands of pounds.
