The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care

social services

and money

The National Health Service (NHS)

Prepared for the Department of Health by Angela Cole with Alison Giraud-Saunders, Foundation for People with Learning Disabilities

Local areas have to -

get better at deciding whether the NHS or social services will pay for someone’s care and support.

use the Framework to make decisions from October 1st 2007. It has things in it to help people make good decisions.

It says that -

The NHS and social services must find out exactly what support someone needs with their health before deciding who will pay.

If someone has a ‘primary health need’, the NHS must pay the whole bill for their care and support.

A ‘primary health need’ means that the person mostly needs help because of their health problems.

new form

And… If the NHS pays the full bill,

they will decide how support is provided.

If someone only needs a small amount of support because of their health problems, the NHS will pay for that, but social services has to pay for most of the support the person needs.

Each local area needs to work in this new way.

We will pay

social services

The health service

Three main questions to ask -

1. Does the person need ‘continuing care’?

2. Does the person have a ‘primary health need’?

3. Does the person need some healthcare or nursing

support as part of their overall care plan?

Three steps …

Step 1. The NHS Continuing Healthcare Checklist is used to identify people whose care and support may be fully funded by the NHS.

Step 2. Health and social services staff work together to get an overall picture of a person’s healthcare and support needs. They use the Decision-Support Tool and recommend to the PCT whether support should be funded or not.

Step3. The PCT makes the funding decision. The recommendation should be followed in ‘all but exceptional cases’.

Helpful questions…

How can we make this work well in our area?

What needs to be done?