By Rosalind Hughes, founder, Just Caring Legal
This week we have been talking to a family whose relative is ready for hospital discharge but has significant ongoing care needs. The hospital has point blank refused to do an NHS Continuing Healthcare assessment, citing “Government guidelines”. Can the hospital do this, even though the lady clearly has ongoing care needs that may indicate a primary health need? What exactly are these new rules around NHS Continuing Healthcare assessments and hospital discharge? Are hospitals washing their hands of NHS Continuing Healthcare assessments?
The short answer is yes. Hospitals are washing their hands of NHS Continuing Healthcare assessments
It has long been a goal of NHS England to reduce the number of care eligibility assessments going on in hospitals. Now it appears it has used the pandemic to rid hospitals once and for all of this responsibility. In so doing, it has solved many of its historic bed-blocking problems in one fell swoop.
The document in question is the Hospital Discharge Service: Policy and Operating Model which snuck in late in August 2020 under cover of Covid-19. It states that eligibility funding assessments for care and health needs should no longer take place in acute hospital settings.
Under this model, the NHS funds the cost of post-discharge care for up to six weeks after leaving hospital. People being discharged to a care home for the first time will receive a place via Capacity Tracker. This is the bed-finding system used to speed up discharges into care in the Covid era. The care home place should be free to the individual for those six weeks.
The Clinical Commissioning Group (which administers NHS CHC) must carry out any CHC assessments during this period. And to focus their minds, the discharge support funding will stop after the end of the sixth week. If the CCG has not reached its eligibility decision in this time frame, the new policy says they should carry on paying for care until they do.
The first step in an NHS eligibility assessment is usually a checklist. This is a screening tool that indicates if a full Multi-Disciplinary Team assessment is necessary. The worry is that given the new deadlines, CCGs are limiting the number of CHC assessments they have to carry out by denying a checklist is necessary.
Our advice: insist on your right to an NHS eligibility assessment
Where it is clear your relative has significant ongoing care needs that require residential or nursing care, they must receive at least a checklist assessment. This is set out in NHS Regulations known as the Standing Rules. Section 21 (2) of the Standing Rules says the relevant NHS body (in this case the CCG) “must take reasonable steps to ensure that an assessment of eligibility for NHS Continuing Healthcare is carried out in respect of a person for which that body has responsibility, in all cases where it appears to that body there may be a need for such care.” According to the National Framework for NHS Continuing Healthcare, which CCGs must by law have regard to, this will normally apply in all cases where an individual requires a care home placement and has significant support needs.
Our second piece of essential advice
Don’t agree to a financial assessment until the CCG has carried out an NHS CHC assessment.
Whether someone may be eligible after hospital for NHS CHC depends on the nature, intensity, complexity and unpredictability of their care needs. If they are beyond what the local authority would be expected to provide, the NHS should meet these needs in full. And this includes their accommodation if necessary. This is, like all NHS care, free at the point of use. That means no means tests, no caps, no top-ups. The local authority should not ask to see your accounts until it has been established whether you are eligible for this.
If you need help during this turbulent time, give us a call
Going into long-term care following acute illness is a huge life event. It can be a devastatingly difficult and emotional time for the person and their whole family. Now add to this the urgency, pressure and lack of choice that these new discharge rules introduce. It is a recipe for complete meltdown! So if you are struggling to cope, that is no surprise at all. If you feel your rights are being side-lined, why not give us a call or email us? We will listen with compassion and care, and give you our best assessment of your case. This initial call is free. Then, we can give you as much support and advice as you need to ensure your relative gets the care they deserve.