Funding health care needs

NHS Continuing Healthcare (CHC) is a package of care that is:

• Fully funded by the NHS
• Provided to individuals aged 18 or over
• Designed for those with complex, long-term health needs arising from disability, accident, or illness

Eligibility is determined through a comprehensive assessment using the Decision Support Tool (DST). The key test is whether the person has a “primary health need”—meaning their care needs are mainly health-related rather than social care. 

As it is funded by the NHS it can only pay for healthcare needs, not social care needs.  

CHC can be delivered in various settings:

• At home
• In a care home
• In a hospice or other facility

It is not means-tested, so financial circumstances do not affect eligibility. 

The ICB has not changed CHC eligibility criteria and continues to follow the national framework.

Recipients of CHC who have questions or complaints about how their package of care is assessed can contact the ICB’s Patient Experience Team on nnicb-nn.patientexperience@nhs.net or follow the appeals process as explained in the letters issued following completion of the Decision Support Tool process. 

Continuing Healthcare and Joint Packages of Care (Adults) Commissioning Policy

NHS Children’s Continuing Care is a package of care provided for children and young people up to the age of 18 who have complex health needs arising from disability, accident, or illness. Eligibility is determined through a detailed assessment process, which considers the child’s physical, emotional, and social needs.

The assessment is carried out by a multidisciplinary team, working closely with the child, their family, and relevant professionals. If a child is found eligible, the care package is fully funded by the NHS and can be delivered in a range of settings, including:

• at home,
• in a care home,
• or in a hospice.

The aim is to ensure that children and their families receive tailored support to meet their individual needs. Families with questions or concerns about the assessment or their care package can contact the ICB’s Patient Experience Team at nnicb-nn.patientexperience@nhs.net.

Children and Young People’s Continuing Care Commissioning Policy

NHS Children’s Continuing Care is a package of care provided for children and young people up to the age of 18 who have complex health needs arising from disability, accident, or illness. Eligibility is determined through a detailed assessment process, which considers the child’s physical, emotional, and social needs.

The assessment is carried out by a multidisciplinary team, working closely with the child, their family, and relevant professionals. If a child is found eligible, the care package is fully funded by the NHS and can be delivered in a range of settings, including:

• at home,
• in a care home,
• or in a hospice.

The aim is to ensure that children and their families receive tailored support to meet their individual needs. Families with questions or concerns about the assessment or their care package can contact the ICB’s Patient Experience Team at nnicb-nn.patientexperience@nhs.net.

Continuing Healthcare and Joint Packages of Care (Adults) Commissioning Policy

A joint funded package of care involves both the NHS and the local authority (Council) sharing responsibility for a person’s care:

• Health needs are funded by the NHS
• Social care needs are funded by the local authority (and may be means-tested)

These packages are used when a person’s needs are both health and social care related.  For example:

• A person may need clinical care (NHS-funded) and help with daily living activities like washing or dressing (social care-funded)

Joint funding arrangements are governed by locally agreed protocols and there is a local dispute resolution policies when disagreements arise between NHS and council teams.

Decisions within the ICB around the health element of joint funded packages are made based on clinical need, not cost, and involve high-level clinical oversight to ensure fairness and compliance with statutory duties. 

Recipients of Jointly Funded packages who have questions or complaints about the health elements of their package of care has been assessed can contact the ICB’s Patient Experience Team on nnicb-nn.patientexperience@nhs.net

Health Care Contributions to Adult Care Packages Commissioning Policy