Transcript Presentation title here - Lincolnshire County Council

NHS Continuing Health
Care
What is Continuing
Healthcare ?
 NHS Continuing Healthcare is the name
given to a package of care that is
arranged and funded solely by the NHS
for individuals outside of hospital who
have ongoing health needs. It can be in
any setting including your own home or
care home. NHS Continuing Healthcare
is free (Public information booklet)
 CHC is a funding stream
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CHC is Determined by the
Prime Health Need Test
This involves looking at the totality of
the relevant needs
Where that person is, or is to be
accommodated in a care home, where
the health need is more than
incidental or ancillary to the provision
of accommodation which LA social
services are, or would be but for
persons means, under a duty to
provide;
(National Framework 2009, pg9,
section 26)
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CHC is Determined by the
Prime Health Need Test
Or
Of a nature beyond which LA social
services whose primary responsibility
is to provided social services could be
expected to provide
NHS CHC Practice Guidance March
2010 section 4.1
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Role/responsibility of care
providers
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To have awareness/understanding of
implications of CHC on care provision and
finances for individuals
Familiarity with the tools and assessment
process
Care plans and records are up to date and
accurately reflect the individuals needs
This is also relevant to home support
workers as records are vital source of
evidence
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NHS Continuing
Healthcare Checklist
2009
• Checklist cannot be completed by care
home staff
• If individuals is currently FNC and
needs change then contact PCT for
assessment to take place
• If individual is in a residential home
the checklist should be done by District
Nurse or CPN
• Inform individual/family that it is
completed
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NHS Continuing
Healthcare Checklist
2009
•Staff members to assist in the
completion of Checklist – able to
reference supporting evidence
•Checklist may be completed by
ASC worker when undertaking a
review
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Decision Support Tool
what is expected of staff attending
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They know the individual and what
their needs are
Verbal statements can be supported
by care plans and daily records
Detailed completion of HNA prior to
meeting
Ensure that care records and MARs
are present
NHS health professional and the
Local Authority should make the
MDT recommendation.
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Nature
This is about the characteristics of
the individual’s needs
 How would you describe the needs (rather
than the medical condition leading to
them)? What adjectives would you use?
 What is the impact of the need on overall
health and well being?
 What type of interventions are required to
meet the need?
 Is there particular knowledge/skill
required to anticipate and address the
need? Could anyone do it without specific
training?
 Is the individual’s condition
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deteriorating/improving
Intensity
This is about quantity, severity and
continuity of needs
Ask yourself things like:
how severe is this need?
How problematic is it to alleviate the needs and
symptoms?
How often and for how long is each intervention
required?
How much care?
How many carers are required?
Does the care relate to needs over several
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domains?
Complexity
This is about the level of
skill/knowledge required to address an
individual need or the range of needs
How difficult is it to manage the need(s)?
Are the needs interrelated?
Do they impact on each other to make the
needs even more difficult to address?
How much knowledge is required to
address the need(s)?
How much skill is required to address the
need(s)?
How does the individual’s response to
their condition make it more difficult to
provide appropriate support?
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Unpredictability
This is about the degree to which needs
fluctuate and thereby create challenges in
managing them
Ask yourself things like:
Are you able to anticipate when the need(s) might
arise?
Does the level of need often change?
Is the condition unstable?
What happens if you don’t address the need when it
arises? How significant are the consequences?
To what extent is professional knowledge/skill
required to respond spontaneously and appropriately?
What level of monitoring/review is required? 11
Fast Track Tool
 Is appropriate when a person has a
primary health need arising from a rapidly
deteriorating condition that may be
entering the terminal phase
 Can be used when an appropriate clinician
considers that the patient is entering
terminal phase with an increased level of
dependency
 To allow speedy access to services over
and above statutory services
 Appropriate clinician i.e. GP, Consultant,
Registered Nurse, Hospice Doctors who
has detailed knowledge of the patient
 Should be supported by a prognosis
 Needs to be authorized by CHC
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Fast track Tool
• It is not appropriate for individuals
who are receiving FNC to be Fast
track, the individual is in a safe
nursing bed and it is not to be used as
a switch of funding stream.
• District nurses make the application
for CHC funding using Fast track
process for individuals in residential
placements
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Thank you for attending!
Continuing Healthcare staff
Welton House
Lime Kiln Way
Lincoln
Tel:01522 574260
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