Reintroduction of CHC (continuing healthcare) assessments with effect from 1 September 2020

The Department of Health and Social Care has released new guidance surrounding the reintroduction of CHC (continuing healthcare) assessments with effect from 1st September 2020.

The guidance can be accessed HERE.

Review of and compliance with this guidance is essential for anyone working within the CHC assessment process – therefore whilst aimed predominately at CCGs and those CSUs who support CCGs in the CHC assessment process, the detail within the guidance is relevant for:

• those in Acute Trusts facilitating the discharge process;
• social care providers supporting individuals;
• local authorities who will start to pick up a greater share of funding; and
• individuals and their families who may need to start contributing to a package of care that the NHS has funded throughout lockdown.

The CHC assessment process will recommence with effect from 1st September 2020.

CCG staff re-deployed during the pandemic will need to return to post and re-start assessments.

Assessments, three-month reviews and annual reviews which have not taken place since lockdown started, will now need to occur so timetabling and resource allocation will be important to manage the backlog of cases.

A change in process will also be introduced from 1 September, to implement CCG discharge to assess responsibilities in line with the hospital discharge service policy and operating model.

CCGs and CHC teams are encouraged to work with local authority colleagues and where appropriate for patients to only be assessed once, as opposed to twice via a CHC and also a Care Act assessment. Where this occurs, it is very important that a process is agreed between CCGs and their local authority counterparts, including the management of disputes around eligibility and funding.

The National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care has not changed and any processes followed and decisions taken must continue to adhere to those pre-existing requirements.

Information to all those involved in and affected by the CHC process, should as ever, be as clear as possible. Those individuals whose care has been funded thus far, but who may now have to contribute to the costs of their care, must be handled consistently and carefully and this should follow on from clear information provided to them previously around this likelihood.

Assurance and governance processes need to be as robust as ever around decision making, audit and peer review and regular situation reports as to how the deferred decisions are now being progressed.

The new discharge to assess process will allow assessments to occur within the first 6 weeks post discharge when recovering services are being funded. Close working will be required between teams in relation to those individuals who are not being discharged home without further input. 6 weeks of reablement and/or rehabilitation funding will be available to support individuals and it is expected assessments and decisions regarding long term care and funding have been determined by the end of that 6 week period. After the 6 weeks, normal funding rules will apply. CCGs and local authorities will want to agree a process regarding funding from week 7 for those cases where a final determination has not yet been reached.

Individuals funded through Covid discharge arrangements between 19th March and 31st August should be reviewed as soon as practicable and moved onto traditional funding arrangements. CCGs will be reviewed against their progress for achieving this.

There is a lot for CCGs to do in a short space of time to be ready and functioning on 1st September. Hempsons can assist with the review of any new processes or dispute resolution procedures required between CCGs and local authorities and advise on the resolution of any disputes over funding between parties and with families.