Continuing Healthcare and the NHS 10 year plan
What are the likely impacts of the NHS 10 year plan on NHS Continuing Healthcare?
Continuing Healthcare (CHC), the care arranged and funded by the NHS for individuals with significant ongoing health needs in the community, is not singled out in the NHS 10 year plan. The plan recognises a shift towards prevention and reduction on reliance on hospital care, and move to community based care with emphasis on supporting individuals at home and within the community, the expansion of personalised care planning and support of patient choice all of which should place CHC at the centre of the NHS plan.
The focus in the 10 year plan on personalisation and proposed expansion on the use of personal health budgets, a key element of CHC, supports increased flexibility and choice for patients but requires ICBs to ensure clear structures and governance to ensure ongoing accountability.
At a practical level, the NHS plan’s focus on technology and digital care is intended to speed up eligibility assessment, improve coordination and remote monitoring. Whilst the plan also identified NHS workforce as a key theme, it does not specifically address the how an already stretched CHC workforce is required to meet the increased complexity of needs in an ageing population and the existing delays and shortages in social and health care provision.
It is envisaged that the focus on ICSs will improve the relationships and working between the NHS and social care, enabling a reduction in disputes, and faster decision making. This would enable more efficient and effective implementation of funding for CHC eligible individuals. The plan also anticipates that the Better Care Fund will remain central to joint funding of health and social care with more resource aimed at community-based services.
Whether integrated care boards (ICBs) and local authorities (LAs) can truly improve joined-up working remains to be seen, especially given the significant financial pressure on both NHS and social care funding. The increased demand and limits on NHS funds risk an increase in delays, tighter eligibility and needs not being met. How ICBs meet the ongoing challenges will require innovation, clarity and increased coordination. It is understood that work, including joint working groups, is ongoing as part of the model ICB blueprint. This is to ensure that delivery issues are further considered. Further clarification as to the transition as to where CHC sits within the wider ICB is anticipated.
How Hempsons can assist ICB CHC teams
Hempsons recognise the significant conflicting demands on ICBs, specifically in relation to CHC provision. These include funding, patient requirements, frequent challenges with the Court of Protection, capacity of workforce, and eligibility disputes. In whatever way forward is determined by ICBs to deliver CHC having regard to the 10 year plan, Hempsons are able to support the work of CHC teams. Hempsons have extensive experience in providing advice and representation to ICBs in respect of CHC which includes:
- CHC dispute resolution
- Responsible commissioner disputes
- CH restitution claims
- Patient disputes and claims
- Representation in Court of Protection welfare applications and s21A challenges
- COPDoL applications
Hempsons can offer bespoke training to ICBs to include:
- Understanding the CHC Framework and funding, Choice and Equity
- Court of Protection applications for CHC patients, Deprivation of Liberty safeguards and applications
- Delayed discharges and the responsibilities of the ICB