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Coping with increased demand for NHS Continuing Healthcare (CHC)

In a nutshell, NHS Continuing Healthcare (CHC) is a package of care for adults aged 18 or over which is arranged and funded solely by the NHS. In order to receive NHS CHC funding, individuals have to be assessed by Clinical Commissioning Groups (CCGs) in line with the National Framework for NHS Continuing Healthcare and NHS funded Nursing Care (Revised 2022) to determine whether the individual has a ‘primary health need’.

CHC is an essential Health service that the most vulnerable in our society depend on. With the challenges of Covid-19, health and care professionals have had to deal with an exaggerated backlog. As the aftermath continues, around a third of England’s’ NHS staff are considering quitting their job and a fifth share that they may leave the health industry altogether. It’s undoubtedly a more pressured working environment than before the pandemic, and it’s time we found a way to allow health and care professionals to get back to what they are best at, cut the transactional aspects down and focus on the provision of care to those who need it.

Whilst CCGs continue to experience an increase in CHC workload, the new 28-day funding infrastructure for Discharge to Assess (D2A) has resulted in an increase in referral rates for CHC consideration. This has heightened health and social care professionals’ workload and has put more pressure on the time frame to assess their patients.

To help tackle the drastically increasing workload and CHC backlog, the implementation of Integrated Care Systems (ICSs) and the creation of Integrated Care Boards (ICBs), aims to create a single system across both health and social care. ICBs will see the merging of CCGs and enable the NHS to avoid duplicating jobs and to begin pooling resources. This could lead to a more efficient system resulting in operational and financial efficiencies– that can be re-invested in core services.

It has long been identified that there are regional and local variations as highlighted in the Parliamentary and Health Service Ombudsman’s Report 2020; Continuing Healthcare: Getting it right the first time. These regional variations have become more apparent due to misunderstanding of processes and differing opinions. The CHC delivery framework is set out in the National Framework for NHS Continuing Healthcare and NHS funded Nursing Care (Revised 2022) but is often misinterpreted. To help synchronise CCGs and retain dedicated health and care professionals, we’re welcoming the implementation of ICSs and the creation of ICBs. The organic collaborations that are rolled out with ICSs has the potential to be transformational for both health and social care professionals and those accessing services. Following rigorous and transparent assessments, health and care professionals will be realigned and avoid making conflicting decisions.

Exhausted and strained, almost half of NHS staff in England have reported feeling unwell from work-related stress – the highest rate recorded in the past five years.

Experiencing greater strain, the NHS had to prioritise and could no longer function at average capacity. As we recover from COVID-19 and reassess pain points felt across the workforce, it is encouraging to see that the NHS has made investment in its people a number one focus in its ‘2022/23 priorities and operational planning guidance’.

As things return to a new normal, there is an opportunity for health and care providers to come back even stronger. Helping CCGs and ICBs to deliver fairer care, ICSs will be rooted in the needs of people, communities, and places. Regaining control over the CHC backlog, improving morale, and creating a seamless thread of collaboration between health care and social care should become a more streamlined process.

Imagine being told that you’re moving house tomorrow and have little control over where you’re moving to and how much it will cost. Imagine leaving your home abruptly after a health crisis and never returning to it again. This happens to people every day. There needs to be a refocus on getting patients home or assessing patients in their home or an environment close to their home, as this hasn’t always been the case.

Improving the assessment process of CHC and to enable safe and timely discharge from hospital, the Department of Health introduced funding for the 28-day assessment period for CCGs to assess patients from the comfort of their usual environments. It is imperative that, wherever possible, ICSs support the return to home for assessment, implementing a D2A model where going home is the default, with alternative routes for people who cannot go straight home. It’s more than good practice. It’s the right thing to do.

Approaching a fairer future in NHS Continuing Healthcare, UB Healthcare provides ICSs and ICBs with an efficient solution. UB Healthcare has developed robust methodologies and has an expert workforce available to support clients flexibly, allowing health and care professionals to regain their focus and passion for the job they love.

UB Healthcare is ready and waiting to help CCGs tackle the deferred activity and get back to more pressing priorities. We can help with the management and assessments of new applications for NHS Continuing Healthcare and NHS-Funded Nursing Care as well as reviews (CHC, FNC, Section 117, Joint Funded, Fast Track/EoL) of existing patients and more. We can help you take back control!

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