CHC / Coughlan & Grogan Judgements / Pointon Ruling / NHS Contuing Healthcare / NHS FNC / Hospital Discharges * ALL HERE

[Chris From The Gulag]

NEW SECTION ADDED JUST TO EXPAND ON THE CONFUSION OUT THERE :


WHAT COSTS ARE COVERED BY CHC ... SOCIAL CARE COSTS ???

https://www.continuing-healthcare.co.uk ... care-cover

A snippet :

The package of care is available to people who have significant long term healthcare needs, known as primary health needs and it covers all your care costs such as aiding with washing and dressing, medication provision, continence care, therapies and other complex health needs that would otherwise we carried out by a social worker of social care professional.

WELL WORTH READING IF YOU ARE ASKED TO CONTRIBUTE !!!

[Chris From The Gulag]

Copied over from another thread ... the role of a social worker in CHC :

https://caretobedifferent.co.uk/nhs-con ... -involved/

In essence , as " Care " in the strictest sense , is both adminstered by the NHS AND LAs , the presence of a LA rep is required to
represent their interests ... when it comes to finances and the effect on the LA's budget ... so much for " Care " ... based on
the ability to pay ... not need ?

In which case , a social worker is an odd choice ... not medically trained , nor a glorified bean counter ???

On another thread , the author was told that his caree did not qualify for CHC ... by a social worker !!!

With CHC / NHS Continuing Healthcare being rationed , and LAs cutting back support services beyond the bone , what REAL
function does our social worker serve in all this ... " The fall guy " ???

Hopefully , at some future date , social care will be reunited with it's twin sister , the NHS , and the need for LA involvement
will cease.

( Green Paper , Social Care thread : https://www.carersuk.org/forum/support- ... en%20paper )

[Chris From The Gulag]

New section added .... DEMENTIA ... links are VERY revealing !

[Chris From The Gulag]

Just a quick note to anyone reading this thread.

How does it read ?

Any problems ? Suggestions ? Recommendations ?

Given the complexity , almost impossible to make it read simpler ?

PM me and I'll tackle head on.

[Chris From The Gulag]

You're on your own now ... someone else needs to step into the breach.

CHC ... rationing and everything else connected to this VITAL health service for far too many of our carees.

Many are probably reading this thread for the first time ... never heard of CHC before a poster mentions it in a reply to a thread ?

( Despite the guidelines given to EVERY NHS hospital when considering discharging patients from their care ! )

It literally can be the difference between an extended life ... and a premature death.

8.5 million odd of you out there ... there must be at least one ?

########################################################################

RATIONING : https://www.carersuk.org/forum/support- ... 0RATIONING

HOSPITAL DISCHARGES / " DUMPSTER " THREAD : https://www.carersuk.org/forum/support- ... DISCHARGES

ACTUAL HOSPITAL DISCHARGE BIBLE ( NHS GUIDELINES ) : https://www.nhs.uk/using-the-nhs/nhs-se ... -hospital/:

All three interlock with this MAIN thread.

[Pet66]

Chris
Oh dear, no one will be like you for your detailed help!

[Valarie_2001]

The terrible story's l have read on,here echoed what happened to me, it came to me last year they lie characters assassinate you,and all the while we think how can we get what we are entitled to,
What we all need to do to get their attention is simple when we are passed back to social services dont pay your part of your care contributions,that will get the LA's attention then tell the LA,they can send all the Bill's for your care to the CCG of course the CCG will refuse to pay,so eventually the LA will take you to court,(dont worry the LA still have to provide your care even if you do not pay)make sure your supporters are there with banners ect outside,the public will be curious and the supporters will inform them about continuing healthcare,and what the NHS have been doing for years to sick people,inside the court will be reporters and their is a good chance your case will get coverage in the local papers,then the national papers and hopefully the TV.
You in court will use your defence time informing the magistrates, about the fraud in CHC,and well l expect you will think of other things to expose the government departments.all it needs is for people to fight back,and finally embarrass the LA and NHS,its because they think will will complain and then go away,we have to change and bring all this corruption out in the open
I strongly believe that this way forward will finally pave the way to decent legislation in the future.
Valerie Bradley

[bowlingbun]

Won't work like that though. In reality the home writes Notices to Quit and gives them directly to the frail elderly resident who is slowly dying!

[Bill_2001]

If any reader has NOT picked this up.

Coronavirus Bill which is now law :

https://www.carersuk.org/forum/news-and ... tely-40083

One consequence is for ALL assessments to be delayed whilst the contagion is active.

Your guess will be as good as mine as to when the " All clear " will be given.

Even then , how long before normal NHS services resume ???

Carers UK ... time to update your part of this site ?

[Bill_2001]

CHC / NHS Continuing Healthcare : Effects Of The Coronavirus Bill :

The Coronavirus Act 2020 (the ‘Act’) came into force on 25 March 2020. The legislation is extensive and amends many duties and responsibilities of public bodies in existing legislation across the board.

It should be noted, if at any time the Government suspends provisions contained within the Act, public bodies will need to revert to their duties set out in existing legislation.

Section 14 of the Act changes CCGs and NHS England’s (the ‘Relevant Body’) duties to carry out assessments in respect of Continuing Healthcare (‘CHC’). The Impact Assessment accompanying the legislation confirms that these provisions have been implemented to facilitate discharge from hospital, with the priority being patients who are ready to leave hospital to be discharged rapidly and with the minimum administrative burden.

Section 14 of the Act needs to be considered alongside the Guidance “COVID-19 Hospital Discharge Service Requirements” (19 March 2020) (the ‘Discharge Guidance’) which sets out requirements for health and social care commissioners. Specifically, the Discharge Guidance sets out a ‘Discharge to Access Model’ using 4 clear pathways to facilitate discharge. The specific discharge pathways will be considered further in a supplementary guidance note.

The provisions under Section 14 came into force on 25 March 2020. Of importance, the provisions of the Act apply to obligations that arise before Section 14 came into force i.e. it applies to any request for assessment that has already been made but for which the assessment has not yet taken place. It also applies if the section is “revived” in the future.

CHC Assessments : What is Changing ?

There are a number of key changes under the Act which will impact the way in which the Relevant Body will carry out its functions in respect of CHC assessments.

CHC Eligibility Assessments :

Under the Act, a Relevant Body does not have to comply with its duty under existing legislation to take reasonable steps to ensure that an assessment of eligibility for CHC is undertaken for a person for which that body has responsibility where it appears to that body that:

there may be a need for such care; or
an individual who is receiving CHC may no longer be eligible for such care.

Practically, this enables a Relevant Body to delay assessing an individual for CHC until after the emergency period has ended.

The National Framework :

Whilst this provision of the Act is in force, a Relevant Body is not required to have regard to the National Framework in so far as it relates to its duty to assess.

NHS Funded Nursing Care :

In addition, the duty of a Relevant Body to assess for NHS Funded Nursing Care (‘FNC’) only applies if a Relevant Body chooses to undertake an assessment of eligibility for CHC.

It should be noted that, if despite the provisions in the Act, an assessment of eligibility for CHC is undertaken, the Relevant Body must ensure that assessment is carried out in accordance with the National Framework prior to any assessment for FNC.

Hospital Discharge : What is Changing ?

Under the Act, changes have also been made to the delayed discharge process under Schedule 3 of the Care Act 2014. The effect of these changes means that it will no longer be necessary to consider CHC prior to any assessment notice being given to a social services authority in respect of individuals who the responsible NHS body does not consider it is safe to discharge until the patients’ needs for care and support are in place.

The Act also provides that the responsible NHS body will no longer be required, as part of the assessment notice, to confirm whether or not consideration has been given as to whether the patient should be provided with CHC, and the result of that consideration. However the new discharge process is likely to put the financial and commissioning burden on the CCG. The Discharge Guidance supplements the change in legislation to shift patients who are likely to need ongoing care onto an NHS-funded discharge pathway.

How Does this Affect Practice ?

CCGs:

It is anticipated that there will be a significant backlog of CHC assessments following the emergency period which will result in future resource implications. The Discharge Guidance suggests that a handling plan will need to be developed to enable the system to ‘normalise’ following the emergency period.

Financially, there may be an impact on CCGs funding under the discharge to assess arrangements as part of the hospital discharge pathways for longer periods than usual. The Discharge Guidance provides that the COVID-19 emergency money can be used for this purpose.

Whilst these measures have been implemented under the Act, clinicians involved in CHC assessments and reviews are required to assess the needs of highly vulnerable individuals and to commission relevant care. Notwithstanding the impact of the Act, it is important that care packages are commissioned to meet the needs of these individuals in those cases where provision is deemed necessary in the circumstances.

The Act does not address CCGs responsibilities in respect of CHC reviews or individual requests to review an eligibility decision (i.e. via the Local Resolution Process) however the Discharge Guidance provides some clarification as to expectations on CCGs during the emergency period –

response times to individual requests to review an eligibility decision will be relaxed; and
CCGs are expected to take a proportionate view to undertaking 3 and 12 month CHC reviews and will need to ensure that any concerns raised are appropriately addressed.

Hospital Discharge:

The Impact Assessment accompanying the Act provides that individuals who the CCG considers may be eligible for CHC funding will be directed towards NHS-funded discharge routes and assessed for CHC following the conclusion of the emergency period.

The Government has published the Discharge Guidance which provides further guidance on the 4 hospital discharge pathways and how local partner organisations should work together. We will be considering this as part of a separate guidance note.

Assessments:

It may also be the case that where CCG nursing staff are diverted to frontline care, there may be delays in CHC assessments for patients already in the community. Similarly, there may be delays for CHC assessments for individuals who are on the acute hospital discharge pathway.

Providers:

It is clear that an assessment notice under Schedule 3 of the Care Act 2014 can be served on a social services authority without a CHC assessment having taken place. The need for the notice itself to stipulate if an assessment has considered whether CHC should be provided and the result of that consideration is no longer required – this essentially could allow notice to be given at an earlier date. Instead of taking such steps, the intention is for there to be cooperation between social services authorities, CCGs and providers to implement the Discharge Guidance.

More on the web site from which the above is an extract :

https://www.bevanbrittan.com/insights/a ... sing-care/


Bottom line ?

How many more carers will now be providing nursing care to their carees as CHC / NHS Continuing Healthcare has now been , effectively , withdrawn to new applicants ???