Why have you developed this policy?

We have developed this policy to ensure that all areas within the ICB operate in the same way. The policy and principle have been developed to ensure that all individuals are treated equitably regardless of where they live and to ensure that the ICB manages public funds wisely.

Why didn’t you have one before?

Some areas, Kirklees and Calderdale had local procedures which were very similar to the policy we have developed. The other areas, Bradford and Craven, Leeds and Wakefield began developing their policies in March 2020. Unfortunately this needed to be put on hold due to the COVID-19 pandemic and later as the organisations were merging to become NHS West Yorkshire ICB.

Are you going to cut my care?

No, you will still be offered care to meet your assessed needs. However, your care may not remain the same at the point of review as it is currently provided, if there is a more cost-effective way of delivering your care. Despite this, everyone’s care needs will be assessed thoroughly and appropriately to make sure they are supported in the most appropriate way possible.

What if I do not like the options I am offered?

The new policy has a full appeals and complaints process, and this will be made available both in writing and on our website.

I have a local authority support package that works well. I'm now eligible for NHS continuing healthcare – will my support package change?

If you're concerned about changes to your care package because of a move to NHS continuing healthcare, your ICB should talk to you about ways that it can give you as much choice and control as possible. This could include the use of a personal health budget, with 1 option being a "direct payment for healthcare".

Can I refuse an assessment for NHS continuing healthcare? If I refuse, will I be able to get services from my local authority?

Consent is not needed for completion of assessments (CHC Checklists, Decision Support Tools (inclusive of FNC by default) and Fast Track), or collation and sharing of information with:

  • Care Teams
  • Health and Social Care Staff

But consent is needed to share personal information collected for, and as part of, assessments (Checklist, Decision Support Tool (inclusive of FNC by default) and Fast Track) with third parties, such as family, friends or representatives, at the beginning of the process.

There is a legal limit to the types of services that a Local Authority can provide. If you have any concerns about being assessed for NHS continuing healthcare, the ICB should explore your reasons for this, and try to address your concerns.

If someone lacks the mental capacity to consent to sharing of information with third parties (other than Care Teams or Health and Social Care Staff), the principles of the Mental Capacity Act will apply and a best interests decision may be needed.

My relative is in a care home and has become eligible for NHS continuing healthcare. The ICB says the fees charged by this care home are more than they would usually pay, and has proposed a move to a different care home. I think a move will have a negative effect on my relative. What can we do?

If there's evidence that a move is likely to have a detrimental effect on your relative's health or wellbeing, discuss this with the ICB. It will take your concerns into account when considering the most appropriate arrangements.

If the ICB decides to arrange an alternative placement, they should provide a reasonable choice of homes.

Is it possible to pay top-up fees for NHS continuing healthcare?

No, it is not possible to top up NHS continuing healthcare packages, like you can with local authority care packages.

The only way that NHS continuing healthcare packages can be topped up privately is if you pay for additional private services on top of the services you're assessed as needing from the NHS. These private services should be provided by different staff and preferably in a different setting.

Can I request an assessment for a previously unassessed period of care?

You may be able to make a request to consider your eligibility for a previously unassessed period of care (PUPoC) if all these criteria apply:

  • you should have previously been considered for NHS CHC eligibility, but were not at the time
  • you have fully or part-funded your care

These requests are usually only considered for periods of care after April 2012