An analysis of calls to our helpline has raised concerns around screening practices for NHS Continuing Healthcare (CHC) eligibility during the pandemic.

The usual way to determine if a patient should be assessed for CHC eligibility is through a screening process. The ONLY screening tool that is sanctioned by the Department of Health and Social Care is the CHC Checklist. However, we have heard from hundreds of families whose loved ones were denied a CHC assessment through unsanctioned screening methods.

This practice could mean that some people are now paying thousands for care that they are entitled to have funded by the NHS.

What is NHS CHC and how is it assessed?

NHS CHC is a fully-funded package of care that some people in England are entitled to as a result of disability, accident or illness. It covers the full cost of the person’s care and residential accommodation.

Eligibility for CHC should usually* be determined by a two-step process. The first step is by completion of the NHS CHC Checklist; a screening questionnaire that should be filled in by a trained health or social care professional. If the patient meets certain criteria, they are referred to have a full assessment to see if they are eligible for CHC.

Patients unaware they’re missing out

During the NHS emergency period in 2020, changes were made to hospital discharge, so that care assessments were carried out afterwards. This was to ensure patients left hospital as quickly as possible when they were clinically fit to leave.

Beacon advisers began to hear of more and more instances where the initial screening for CHC had been carried out by tools other than the CHC Checklist. Callers sent copies of the paperwork that had been used. We were alarmed that these tools often ruled patients out of referral for a full assessment, when the Checklist may have ruled them in.

Some could now be paying thousands for care that they are entitled to have funded by the NHS.

What can be done?

We call on NHS commissioners across England to ensure that their CHC screening processes are compliant with the National Framework. This means using only the CHC Checklist to determine if patients should have a full assessment. If other methods have been used, the patients involved should be re-contacted and offered a Checklist.

We also urge families who were told in 2020 that a patient did not meet the criteria for a full CHC assessment, to check that the Checklist was used. If they know or suspect that another method was used, they should flag this to their local CHC team and ask for a Checklist to be completed. If found eligible for CHC, care funding could be backdated to the original assessment.

You can see and download a blank CHC Checklist from the gov.uk website.

If you’re unsure how to proceed, Beacon’s expert advisers are available to provide free advice on this issue. Complete a contact form and we will get in touch.

From the MD

Dan Harbour, Beacon’s Managing Director, said: “There were major changes to the discharge and assessment procedures during the heat of the pandemic, many of which were welcome. However, some poor practices around CHC also crept in, in particular the use of wrong and potentially unlawful methods to screen people in or out of having a full and fair assessment for NHS CHC.

“Our helpline advisers report that this practice thankfully now appears to be waning. What concerns us is that perhaps hundreds, possibly thousands, of people have no idea they may have wrongfully missed out.

“I would encourage families to revisit any paperwork they have from the time to try to determine if the Checklist was used in the screening process. If not, they have a right to the proper process. Our advisers are on hand, as always, to answer any questions and help with next steps, for free.”

How we can help

Our expert advisers can answer your questions on any aspect of NHS Continuing Healthcare in England. We have helped thousands of people to understand the eligibility criteria, navigate the assessment process, understand the Decision Support Tool and your assessment, review a decision, or begin an appeal. We can also talk to you about funding policies and issues in your area.

Contact us by visiting our Talk to Us page and completing the contact form, or call 0345 548 0300 during office hours.

*In some instances, people are referred directly for a full assessment, with no screening step at all. And for people at the end of their lives there is a different, fast-tracked, process.