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Continuing care

This page is a guide for anyone who may need ongoing care and support from health and social care professionals due to disability, accident or illness. Below we explain how we decide whether someone is eligible for care funded entirely by the NHS (known as continuing care or continuing healthcare).

NHS continuing healthcare – for ages 18+

NHS continuing healthcare is the name given to a package of care arranged and funded solely by the NHS for a person aged 18 or over. It’s designed to support people who have ongoing healthcare needs, outside of hospital care. This might be the result of disability, accident or illness.

NHS continuing healthcare is free (unlike support from local authorities, which may involve you making a financial contribution, depending on your income and savings).

You can receive NHS continuing healthcare in any setting – including your own home or a care home.

North East and North Cumbria Integrated Care Board (ICB) is responsible for deciding the appropriate package of support if you are eligible for NHS continuing healthcare.

Decisions about who is eligible for continuing healthcare are guided by the National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care. This is designed to ensure that everyone assessing or delivering continuing healthcare does so in the same way.

The Department for Health and Social Care’s leaflet, ‘NHS continuing healthcare and NHS-funded nursing care’ outlines how continuing healthcare works.

You may find the Government's Easy Read guide to continuing healthcare is helpful.

Anyone who is assessed as having a certain level of clinical need may receive continuing healthcare. It's not dependent on a particular disease, diagnosis or condition, or on who provides the care or where that care is provided. 

If you apply for continuing healthcare, you will have an assessment of your needs, to see if you are eligible. If the assessment finds that you have a ‘primary healthcare need’, you should be able to receive NHS continuing healthcare funding. This would be reviewed regularly, and your care package may change if your clinical needs change.

The first step is usually for a health or social care professional to complete the NHS continuing healthcare checklist tool. This shows whether your clinical needs are at a level that should be considered for a full assessment.

The result of this check is then be passed to us the ICB, whether it is positive or not.

If the check does not suggest that you should be considered for continuing healthcare at this stage, it's still possible to be reviewed again in future if your needs change.  

The next step is a full assessment by two or more health and social care professionals (known as a multidisciplinary team or MDT). You will be able to take part in this assessment.

The team will complete a ‘decision support tool’ (or DST), using information about your health needs, from yourself and the people who provide your care.

If your condition is getting worse and you need an urgent package of care, you may need a 'fast-track referral'. This is to ensure you get the care you need, with NHS funding.

In this situation, a doctor or health professional will complete the ‘continuing healthcare fast track tool’ for you. Any services provided under this process will be subject to review, and may be amended as your health needs change.

If you are not eligible for NHS continuing healthcare, your local council will discuss with you whether you can get support from them instead. The letter telling you about the decision would include details of how to appeal. The Department of Health and Social Care website provides more information about what to do if you’re not happy with a decision. 

NHS children's continuing care – for under-18s

Children and young people may have complex health needs – for example, due to a long-term health condition or an accident. A children's continuing care package of support may be needed if routine services like your GP, hospital or community services cannot meet their complex health needs.   

North East and North Cumbria Integrated Care Board (ICB) is responsible for deciding the appropriate package of support if a child or young person is eligible for NHS continuing healthcare.

If you or your child needs continuing care, the ICB's staff can meet with you to develop a package of care to meet the needs that have been identified. The ICB's staff work within the national framework for children and young people's continuing care.

Children and young people with complex health needs may also need support from social care and special education needs services run by your local council. In some cases, a package of support can be jointly commissioned by the NHS and your local council.

Eligibility for children's continuing care is not based on a diagnosis or a condition. Instead, we would carry out a holistic assessment to identify any health needs that are not being met.

The first step is usually for a health professional to complete a referral form (with the consent of the family or young person, depending upon their age). In most cases, this would be someone who the child/young person already knows.

A 'pre-assessment checklist' is then completed by the ICB. This highlights whether the young person may have unmet health needs requiring a full assessment. 

If a full assessment is needed, you and your child/young person will be invited to meet with a multidisciplinary team (sometimes known as an MDT). We will do the best we can to keep the number of meetings to a minimum for you.

A nurse assessor then uses the information you and others have provided to complete a ‘decision support tool’ (or DST) to identify your child or young person's level of need in a number of areas.

If a child or young person's health condition may be entering the end-of-life stage, you may need a package of support to be provided quickly. In this situation, the health professionals involved in the care of your child/young person will arrange a fast-track referral for continuing care funding.

The ICB reviews every support package three months after it starts, and then at least once a year. This helps to make sure the package of support can be adapted if your child/young person's needs change.

If your child/young person is not eligible for children's continuing care, your social worker or another professional will discuss the support available with you. Families have the right to appeal the outcome of the initial assessment and we will provide details of how this works in a letter following the assessment.

Continuing healthcare for children and young people comes to an end at the age of 18. At that point, the ICB and your local council will offer support so that your child/young person's needs can be considered for adult continuing healthcare.

Contact us

To find out more, contact your local continuing healthcare team at:

Adults

North Cumbria

necsu.chcintakecorrespondence@nhs.net

01642 746 848

Northumberland

nhc-tr.chcnorthumberland@nhs.net

01670 536 459               

North Tyneside

nencicb-nT.chc@nhs.net

0191 223 6513                

Newcastle and Gateshead

nencicb-ng.continuinghealthcare@nhs.net

0191 223 6503  

South Tyneside

chc.commissioning@southtyneside.gov.uk

0191 402 8184                 

Sunderland

nencicb-sun.chc@nhs.net

0191 283 1296                

County Durham and Darlington

necsu.chcintakecorrespondence@nhs.net

01642 746 848

Tees Valley (Redcar and Cleveland, Middlesbrough, Hartlepool, Stockton)

 

necsu.chcintakecorrespondence@nhs.net

01642 746 848

Children

North East

necsu.childrenscontinuingcare@nhs.net

01642 746 848

North Cumbria

nencicb-cu.continuing.healthcare@nhs.net

If you need someone to help you understand how the system works, an advocacy service can help you. Please ask your local continuing healthcare team for details of an advocacy service near you.

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