Are NHS Continuing Healthcare assessments a fair system?


Continuing Healthcare (CHC) is a package of care which is arranged and funded by the NHS. To receive this budget plan, you need to be assessed by health professionals to decide if your health needs qualify for the funding.

I experienced this assessment process last week and found it very daunting, stressful and frankly a waste of time. It was concluded that I would not be eligible for continuing healthcare funding.

How does the assessment process work?

You begin by completing a checklist of your needs with a social worker or other healthcare specialist. There are multiple sections including mobility, nutrition and psychological/emotions, which are scored A-C based on severity (C being no evidence or low, B being moderate and A being high risk/severe). This checklist will then determine if a referral for a full assessment is required.

Once a referral for a full assessment is made, the patient, their relative, carers, social worker and other health professionals have to complete “a view of health needs” form, giving detailed evidence of health problems occur within each section in the patient’s life. These are all collected and checked through by a CHC professional.

The next stage would be to have a face to face assessment with the patient and the health professionals involved in their care. The meeting will consist of completing a Decision Support Tool (DST) form where, as a group, they will decide if a particular section should be seen as “No need, low, moderate, high, severe or priority”. It is like a score system where the more high and severe scores you get, the likely you’ll get the funding. At the end of the meeting, the patient and relative will leave the room so the health professionals can tally up the scores and discuss the verdict.

My thoughts on the process

Personally, I feel this system is unfair. I understand the NHS is in crisis and can’t fund everybody but deciding in a points system isn’t the way to go. It looks like the only way to get NHS funding is to have all high & severe scores or be terminally ill. In my case, my health can be so unpredictable. One day I’m motivated, physical fine and feel good. Other days I can in a lot of pain, have poor gag reflex and very low moods. Throughout my assessment, only a couple of health professionals gave evidence whereas the rest were either not contacted by CHC in time or were unavailable to attend or send evidence. For instance my eyes are one of the biggest health risks I have at the moment. I am currently treated by senior consultants at Moorfields Eye Hospital. As busy doctors in a high profiled hospital, do you really think they would travel 30+ miles for a meeting? Don’t think so! But also they were unable to even provide evidence of the severity of my eye condition, meaning I had less evidence than I should have had for the assessment.

In addition, within all the forms, there was no section on sensory impairments. So apparently being registered blind is not a health condition despite me having pain in my eyes, administering eye drops frequently and having annual surgery.. Instead I had to include this in the “Other” section of the forms.

Another issue was they would hold the meeting to complete the DST first then back it up with evidence provided. Surely they should’ve checked the evidence, conduct the meeting then make the final decision. So I basically wasted a week filling out forms to find out they’ve not even been read yet.

Overall, I had 1 high, a few lows & moderates and 3 not needed. I believe we should get some funding based on each section. For example I should get some money towards my high score for mobility. If a patient gets 2 highs and a severe they get so much funding towards it.

What are your thoughts on this topic? Should the assessment process be changed? Have you experienced this assessment yourself? Should social services do more to fund disabled people’s care? Share your thoughts and experiences below or on social media.

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