Whilst the vast majority of our work involves proceedings before the Court of Protection, the team at Birketts also advises in relation to Continuing Healthcare Funding.

What is CHC Funding?

CHC Funding (NHS Continuing Healthcare Funding) is a fully-funded package of care which is awarded by the NHS depending on whether a person’s primary need is a health need (irrespective of financial circumstances). The Department of Health produced the National framework for NHS continuing healthcare and NHS-funded nursing care to help decide eligibility for NHS continuing healthcare. If you are eligible and receive care in your own home or in a care home, the services are funded by the NHS at no cost to you. It is important to distinguish NHS Continuing Healthcare from funding from the local authority, the latter being means tested based on your financial circumstances.

Applying for NHS continuing healthcare can be quite complex. Typically, individuals are normally assessed by a healthcare professional using the continuing healthcare checklist to decide whether it is appropriate to undertake a full assessment.

If required, a further assessment will be carried out by a multi-disciplinary team of two or more health or social care professionals. The information gathered will thereafter be used to complete a Decision Support Tool. Assessments are based on an individual’s healthcare need; as such there is not one particular condition that will meet the criteria in every case.

If you wish to challenge a CHC funding decision, the framework referred to above provides broad guidelines to the clinical commissioning groups (CCGs) as to how they should address appeals.

Reasons to appeal may include:

• You suspect that fundamental information was incorrect, missing or not considered at the time of the Decision Support Tool meeting
• You do not agree that the correct recommendation on CHC funding eligibility was made following the Decision Support Tool meeting
• You do not consider the process took place in accordance with the National Framework.

Birketts’ Court of Protection Team has extensive experience with healthcare appeal applications and can provide advice on the following:

• Current applications
• Previous DST/checklist assessments
• Outcomes of local NHS panel meetings
• Making written representations or attending assessment meetings and panel hearings on your behalf
• Alternative routes to securing funding for care if appropriate.

This article is from the autumn 2021 issue of Private Lives, our newsletter covering the key legal and tax issues that individuals face. To download the latest issue, please visit the newsletter section of our website.

To keep up-to-date with the latest news, legal updates and seminar information, please register and select the areas that are of interest to you.