'Continuing Care' Health Funding in the Community
What is 'Continuing Care' ?
'Continuing care' is care and support received in the community, over an extended period of time for a person aged 18 or over, and which is paid for by the local PCT to meet physical or mental health needs which have risen as a result of disability, accident or illness.
Why is it called 'Continuing Care' ?
Care and support at home can either be funded by the Local Council Social Services Department for ' social care' or by the Local Primary Care Trust (PCT) for 'health care' for people with high support needs.
Care at home paid for by a PCT is called 'Continuing care' i.e. 'continuing' to be paid by the PCT for a person at home, even after discharge from hospital.
Who decides what is Continuing Care ?
Before a PCT gives notice to a patient's case to a social services authority for a person to be discharged home, the PCT must take responsible steps to ensure that an assessment for PCT continuing health care is carried out in all cases where it appears that the patient may have a need for such continuing health care in the community.
It is therefore the local PCT which is responsible for undertaking a 'Care Needs Assessment' as to whether a persons care needs meets their criteria for PCT 'continuing care' funding.
Each strategic Health Authority has a set of eligibility criteria for continuing care for their area.
Can a person have a 'Direct Payment' for 'Continuing Care' ?
As is well know a PCT has a statutory duty to provide 'health care' which is "free at the point of delivery." It is therefore generally considered to be illegal for a PCT to give a cash payment direct to a person for continuing care as an alternative to providing free health care.
It has therefore not been generally possible in the past for a person to receive a direct payment (or an individual budget) for continuing care funding at home.
The Government however are to establish 8,000 people pilot projects in 2008/9 for people to receive a direct payment for continuing care funding as outlined in the Darzi Report of 2008.
Can a family member be paid who lives in the same house ?
The guidance has been that "Unless it is necessary to satisfactorily meet the needs of an individual person, it is not permissible to pay someone who lives in the same house" however where ' a need can be established' then the national registration of HCD by the CSCI often gives comfort to funding bodies to agree for family members living in the same house to be paid where HCD takes legal responsibility for the employment of such family members. In such circumstances it is possible therefore for family members to be paid who do live in the same house.
The HCD System solves a legal problem :-
- for individual people
HCD does enable a person to legally gain control of continuing care funding for their support at home by the use of the HCD internet based technology, linked to their Client Trust Bank account and national registration to CSCI standards for all client groups for all England .
- for a PCT
PCT's can offer people this HCD 'Middle Way' internet system infra-structure as a legal method and choice for people to gain control of their 'continuing care' funding for their support at home received from either personal carers or a qualified nurse.
References
Continuing Care (NHS) Responsibilities Directive 2004
Continuing Care Modification Directive 2006
D.o.H.- NHS-Funded Nursing Care – Practice Guidelines 2007
