1. Care Options for NHS Continuing Health Care (CHC) Wirral PCT Board – 12 February 2008 Tina Long - Director of Strategic Partnerships Sheila Hillhouse - Continuing Healthcare Lead

2. NHS Continuing Health Care Complex and highly sensitive area which can affect people at a very vulnerable time of their lives New national guidance sets out a single, national framework for determining eligibility for NHS continuing health care Fair and consistent access to NHS funding across England

3. What is NHS Continuing Health Care? Package of services arranged and funded by the NHS for people outside of hospital with ongoing health needs In any setting, including your own home or in a care home Unlike help from Social Services for which a charge can be made depending on your circumstances

4. Who is eligible for NHS Continuing Health Care? Anyone assessed as requiring a certain level of health care need Not dependant on a particular disease,diagnosis or condition, nor on who provides the care or where the care is given If your overall care needs show that your primary need is a health need, you should qualify for consideration for continuing healthcare

5. Four Indicators for Primary Health Need Nature - type of condition or treatment required and its quality and quantity Complexity - symptoms that interact. Making them difficult to manage or control Intensity - one or more severe needs that require regular interventions Unpredictability - unexpected changes in condition, difficult to manage and present a risk to you or others

6. Care Options for Wirral To manage the process fairly and constructively and apply resource allocation appropriately, Wirral must be able to identify what care options are available for patients eligible for CHC

7. Process Individuals assessed against the national framework Individuals not eligible for CHC may have care package provided by the NHS and Social Services, or solely by Social Services, depending on the nature and level of needs Where Social Services are providing care, the individuals may fund some or all of their care themselves based on a financial assessment NHS care is provided free at the point of delivery

8. Care Options All decided on a case by case basis: in a NHS Hospital independent hospital a specialist unit care home hospice patient’s own home.

9. Factors to be taken into consideration Safe delivery of appropriate care by appropriately skilled staff to meet the needs of the individual Wishes of the patient and/or family members Competing demands on the NHS budget

10. Suitable Alternatives If an individual’s preferred option cannot be supported a clinically suitable alternative would be offered, based on: equity clinical effectiveness safety resource availability

11. Citizens Advisory Group Consultation Exercise: To provide the Board with recommendations regarding resource allocations for individuals who are eligible for CHC, the impact on the Wirral population at large and the competing demands on the NHS budget To analyse the success of this approach of involving the public Views of CAG participants

12. Content Two sessions. Presentations overview of CHC Care options paper Financial report and amount of people on the Wirral in receipt of CHC Discussion Case presentation Recommendations

13. Key Areas of Concern Understanding the decision making process Understanding funding allocated Maintain a level of fairness for those potentially eligible for CHC To raise awareness of CHC for all potentially eligible

14. Recommendation To consider the principles of the Care Options paper to become part of Continuing Health Care Policy for individuals eligible for Continuing Health Care who are registered with a Wirral GP

15. Care Options for NHS Continuing Health Care (CHC)