Understanding NHS Funding Options for Palliative Care

Choosing a care home that truly understands and meets the unique needs of your loved one is paramount, especially when palliative care is required. At St George's Nursing Home in Witham, we are dedicated to providing compassionate and expert palliative and end-of-life care. Understanding the available NHS funding options can help ease the financial considerations during this important time. Two key avenues to explore are NHS-Funded Nursing Care (FNC) and NHS Continuing Healthcare (CHC). This article will outline both, specifically for those requiring palliative care offered at St George's Nursing Home, Witham.

NHS-Funded Nursing Care (FNC)

NHS Funded Nursing Care - Supporting Nursing Needs

If your loved one requires the skilled and compassionate care of registered nurses at St George's Witham, they may be eligible for NHS-Funded Nursing Care. This is a contribution from the NHS paid directly to St George's Nursing Home to help cover the costs associated with their nursing needs. It's important to understand that this funding isn't a direct payment to you.

Key aspects of NHS-Funded Nursing Care:

• Focus on Specialist Nursing Care: This funding specifically addresses the cost of care provided by our registered nurses, experienced in palliative care.
• Set Contribution: The NHS provides a fixed weekly amount directly to St George's Nursing Home.
• Partial Coverage: This funding is specifically for nursing care and does not cover ccommodation, meals, or personal care costs.
• Not Means-Tested: Eligibility for NHS-Funded Nursing Care is not based on your loved one's financial situation, making it a potential support for all residents who qualify.
• Eligibility Criteria: To be eligible, your loved one must:
  - Reside in a care home that provides registered nursing care, such as St George's Nursing Home. - Have been assessed as needing the care of a registered nurse.
  - Not be eligible for NHS Continuing Healthcare.
  

For the most up-to-date details on local NHS health and care services visit:
NHS Suffolk and NorthEast Essex Integrated Care Board (ICB)

NHS Continuing Healthcare (CHC)

NHS Continuing Healthcare - Comprehensive Funding for Palliative and Complex Care Needs

For individuals with significant, ongoing, and complex health needs often associated with advanced illness requiring palliative care, NHS Continuing Healthcare (CHC) offers the possibility of full funding for their care. This can include accommodation costs at St George's Nursing Home Witham, too.

The process for obtaining NHS CHC in North East Essex typically starts with a referral, which can come from various sources, including your GP, hospital staff, social services, or the care home. Following a referral, an initial 'checklist assessment' is usually conducted by a healthcare professional to determine if a full assessment is required. If the checklist indicates potential eligibility, then a comprehensive assessment using the Decision Support Tool (DST) will be carried out by a multidisciplinary team commissioned by the Suffolk and North East Essex ICB.

What is NHS Continuing Healthcare?

NHS Continuing Healthcare is a complete package of care arranged and fundedentirely by the NHS for adults with substantial and complex health needs requiring a high level of support, which can be provided within a nursing home setting specialising in palliative care.

Key Differences from NHS-Funded Nursing Care:

• Full Cost Coverage: If eligible for NHS CHC, the NHS covers all care costs, including accommodation and personal care, not just the nursing element.
• 'Primary Health Need' is Crucial: Eligibility depends on whether your loved one's primary need for care is health related. This signifies that their ongoing healthcare needs are the main reason they require care, and these needs are complex, intense, and/or unpredictable.
• Not Condition-Specific, but Often Relevant in Palliative Care: While NHS CHC isn't tied to specific diagnoses, conditions requiring extensive palliative care often involve the level and type of complex needs that can meet the eligibility criteria.
  

Medical Needs Often Leading to NHS CHC Eligibility in a Palliative Care Setting

While there isn't a definitive list, individuals with the following types of needs, often seen in palliative care, may be eligible for NHS CHC:

• Significant Cognitive Impairment: Such as advanced dementia with significant impact on daily living and safety in the final stages of life.
• Challenging Behaviour: Where behaviours require skilled and compassionate management in a palliative setting.
• Complex Physical Needs: Including advanced neurological conditions or organ failure leading to significant care needs.
• Complex Symptom Management: Requiring specialist nursing input for pain control, Respiratory distress, or other distressing symptoms.
• Respiratory or Muscular Disorders: Leading to significant care needs in the context of a life-limiting illness.
• Limited Mobility and Dependence on Care: Requiring substantial assistance with all aspects of personal care in advanced illness.
• Other Progressive or End-Stage Conditions: Resulting in complex and evolving care requirements.
  

The NHS CHC Assessment Process

Determining NHS CHC eligibility involves a thorough assessment of your loved one's health and care needs, typically involving these stages:

• Initial Checklist Assessment : An initial screening to determine if a full assessment is necessary.
• Full Assessment : A multidisciplinary team uses a Decision Support Tool (DST) to evaluate needs across various domains, including breathing, nutrition, mobility, cognition, behaviour, and other relevant palliative care needs.
• Recommendation and Decision: The assessment team makes a recommendation to the NHS Suffolk and North East Essex ICB, which makes the final decision on eligibility.
• Fast Track Pathway: For individuals with a rapidly deteriorating condition and a likely short prognosis, a quicker 'Fast Track Pathway' is used to expedite the process. This is particularly relevant in palliative care.

Taking the Next Step for Your Loved One at St George's Nursing Home

If you believe your loved one at St George's Nursing Home in Witham might be eligible for either NHS-Funded Nursing Care or NHS Continuing Healthcare, the initial step is usually to request an NHS CHC assessment from the NHS Suffolk and North East Essex Integrated Care Board.

The dedicated and experienced team at St George's is familiar with these funding processes and can offer guidance and support as you navigate the initial stages. Please do not hesitate to discuss these options with us.

Understanding NHS funding options is a vital step in ensuring your loved one receives the specialist
palliative care they need in a comfortable and supportive environment like St George's Nursing Home Witham, with appropriate financial support in place.

More Information on NHS Continuing Healthcare

You can find more information on the NHS Suffolk and North East Essex ICB website, see web link below. You can also contact their Continuing Healthcare Team directly by telephone at 01473 770198 or by email at chc@snee.nhs.uk. Additionally, the ICB's Patient Advice and Liaison Service (PALS) can provide advice, support, and help with any queries or concerns. They can be contacted on 0800 389 6819 or pals@snee.nhs.uk

NHS CHC Resources

- Suffolk & North East Essex ICB website : NHS Continuing Healthcare

- NHS website : NHS Continuing Healthcare

- gov.uk .pdf leaflet : NHS Continuing Healthcare and NHS-funded nursing care

FAQ’S: NHS Continuing Healthcare
Suffolk & North East Essex Integrated Care Board ICB

Q What is NHS Continuing Healthcare (CHC) funded by Suffolk and North East Essex ICB?
A NHS Continuing Healthcare is a package of ongoing care arranged and funded solely by the NHS (specifically, in this region, by the Suffolk and North East Essex Integrated Care Board). It is for adults aged 18 or over who have been assessed as having a 'primary health need' due to disability, accident, or illness. This care can be provided in various settings, including your own home or a care home. It is provided free of charge, and you will not be asked to contribute to the costs.

Q Who is eligible for NHS Continuing Healthcare in Suffolk and North East Essex?
A You may be eligible if you are over 18 and have been assessed as having a high level of complex and ongoing healthcare needs that are primarily health-related. The assessment considers the intensity, complexity, unpredictability, and nature of your care needs. Eligibility is not based on
your financial situation or the setting where care is provided.

Q How do I get assessed for NHS Continuing Healthcare by Suffolk & North East Essex ICB?
A The process usually starts with an initial checklist assessment, which can be completed by a nurse, doctor, other healthcare professional, or a social worker who knows the individual. If the checklist indicates potential eligibility, a full assessment will be carried out by a multi disciplinary team from the Suffolk and North East Essex ICB. This team uses a national Decision Support Tool (DST) to evaluate your needs across various domains. You can also directly request a CHC assessment from the ICB.

Q What is a 'primary health need'? How is it determined by the Suffolk & North East Essex ICB?
A A 'primary health need' means that the main reason for your care is related to your health. It's about the level and type of your overall day-to-day care needs, considering their totality, rather than the reason why you need care or your diagnosis. The multidisciplinary team uses the DST to assess the nature, intensity, complexity, and unpredictability of your needs to determine if the majority of care required is focused on addressing or preventing health needs.

Q What is the NHS Continuing Healthcare Decision Support Tool (DST) used by the Suffolk and North East Essex ICB?
A The DST is a national framework used by the multi disciplinary team to structure the full assessment of an individual's care needs. It covers various care domains (e.g., breathing, nutrition, mobility, skin integrity, communication, psychological and emotional needs, behaviour, etc.). For each domain, the level of need is identified, and this information helps the team determine whether the individual has a primary health need. You can download a copy of the decision support tool referral form here: Full Assessment Decision Support Tool

Q What is the NHS Continuing Healthcare 'Fast Track Pathway'?
A The Fast Track Pathway is used for individuals who have a rapidly deteriorating condition and a likely short prognosis. This process aims to quickly assess and provide immediate NHS CHC funding for their care without going through the full assessment process. A healthcare professional involved in the person's care can initiate the Fast Track Pathway. You can donwload Government guidance here : Fast Track Pathway

Q If I am eligible for NHS Continuing Healthcare in North East Essex, can I choose where I receive care?
A Yes, where possible, the Suffolk and North East Essex ICB will respect your wishes regarding where you receive care, including your own home. If you are eligible for CHC at home, you may also have the right to a Personal Health Budget to manage your care. However, there's no automatic right to a care package at home, especially if your needs require more than eight hours of care per day, night care, 24/7 registered nurse access, or if it's not safe to care for you at home. In such cases, an alternative care home package will be offered.

Q Does having assets or savings affect eligibility for NHS Continuing Healthcare in Suffolk and North East Essex?
A No, eligibility for NHS Continuing Healthcare is solely based on yourhealthcare needs and whether you have a primary health need. Your financial situation, including your assets and savings, is not taken into account. This is a key difference from social care funding provided by the local authority, which may be means-tested.

Q What if I disagree with the NHS Continuing Healthcare eligibility decision made by the Suffolk and North East Essex ICB?
A If you disagree with the decision, you have the right to appeal. Youshould first contact the Suffolk and North East Essex ICB to request a 'local resolution' where they will review the decision. If you are still dissatisfied after the local resolution, you can escalate your appeal to NHS England for an independent review. The ICB should provide information on their appeals process
and timescales.

Q How often is NHS Continuing Healthcare reviewed by Suffolk and North East Essex ICB?
A If you are awarded NHS Continuing Healthcare, your care needs will be reviewed. Typically, there is an initial review within three months, followed by annual reviews. Reviews can also be requested if your needs change. The purpose of the review is to ensure that the care package continues to meet your needs.

Q Can the Suffolk and North East Essex ICB pay for the full cost of my care home if I am eligible for NHS CHC?
A Yes, if you are eligible for NHS Continuing Healthcare and your care needs are best met in a care home, the ICB will fund the full cost of your care, including accommodation, personal care, and healthcare costs. You cannot be asked to 'top up' these fees for your identified health and care needs.