Revised framework for NHS Continuing Healthcare and NHS Funded Nursing Care published and effective from 1 October 2018

The Department of Health and Social Care has published the next incarnation of the National Framework for NHS CHC and NHS FNC which will, in six months’ time, supersede the 2012 versions. It sets out the future policy direction with a greater focus on moving assessments outside of an acute setting.

As before, the revised National Framework incorporates Practice Guidance to support staff delivering NHS CHC and is published alongside the checklist, decision support tool and fast track pathway tool. This 2018 National Framework has been written in conjunction with the Department, NHS England and local authorities and follows an extensive period of external engagement.

The 2018 framework

In broad terms, the National Framework seeks to provide greater clarity to individuals and staff, through a new structure and reflects legislative changes such as the Care Act 2014 since the 2012 version of the Framework was published.

The intention is to clarify five key policy areas, including:

• Setting out that the majority of CHC assessments should take place outside of acute hospital settings.
• Providing additional advice for staff on when individuals do and do not need to be screened for CHC in order to reduce unnecessary assessment processes.
• Clarifying that the main purpose of three and 12 month reviews is to review the appropriateness of the care package, rather than reassess eligibility.
• Introducing new principles for CCGs regarding the local resolution process for situations where individuals request a review of an eligibility decision.
• Providing clearer guidance, including dedicated sections, on: the roles of CCGs and local authorities, NHS FNC, inter-agency disputes, well-managed needs, and the Fast Track Pathway Tool.

DHSC has stated that none of the 2018 amendments and clarifications to the National Framework are intended to change the eligibility criteria for CHC.

All those involved with CHC should read the 2018 National Framework before the implementation date of 1 October. The expectations of commissioners, providers and local authorities are all summarised – we highlight a few areas of focus for CCGs and providers.

For CCGs

They should consider how the processes in the new Framework relate to what is currently in place, and should align their processes accordingly. They should consider whether their responsibilities under the Framework require clearer arrangements to be made with provider and other organisations, and should ensure that that these are built into commissioning processes.

For providers

They need to consider whether their current practice and processes fit with any delegated responsibilities outlined within the 2018 Framework.

Do get in touch if your CCG or provider organisation requires support with CHC and/or getting ready for 1 October.

We will be running training sessions on the new Framework; do get in touch if you would like to book in some training.