Agenda item

(To receive a report from Lincolnshire Clinical Commissioning Group, which provides the Committee with an update on NHS Continuing Healthcare.  Wendy Martin, Associate Director of Nursing and Quality will be in attendance for this item)

Consideration was given to a report from the NHS Lincolnshire Clinical Commissioning Group, which provided the Committee with an update on NHS Continuing Healthcare, a defined package of ongoing care arranged and funded solely by the NHS, where an individual had been assessed and found to have a ‘primary health need’

The Chairman invited the following representatives from the NHS Lincolnshire Clinical Commissioning Group: Wendy Martin, Associate Director of Nursing and Quality and Helen Sands, Continuing Healthcare Clinical Lead, to remotely, present the item to the Committee.

The Committee noted that this item and been circulated as part of the supplement on 10 February 2022.

The Committee was advised of the background to NHS Continuing Healthcare, primary health need, NHS-Funded Nursing Care and the roles of the NHS and Local Authorities.

It was reported that Lincolnshire Clinical Commissioning Group (CCG) had an in-house Continuing Healthcare team and that the team comprised of five main areas, details of which were shown within the report presented.

Details of the expenditure on Continuing Healthcare for 2020/21 was shown on the bottom of page 17 of the supplementary report pack for consideration by the Committee.

During consideration of the item, the Committee raised the following comments:

·       If a patient’s circumstances changed to the point that they were no longer eligible for continuing healthcare, but they still needed support, what measures were in place to ensure a smooth transition to another service.  It was reported that a package of care was not handed over until it was known that there was a subsequent package of care in place.  It was reported further that a 14 day notice period would be given to end continuing healthcare packages and that during that time an assessment would always be done with social care colleagues, and that ongoing discussion would continue with workers to see if any funding needed to be carried on until the package of care was in place;

·       What measures were in place to ensure that accessing the service was not too complicated, and how long, if a patient was not fast tracked, did the process take.  The Committee was informed that there was 28-day process, informed through a checklist of need via the health care worker or social care worker.  The Committee was advised that the process was a national process which could not be changed, and the starting point was receiving the checklist.  It was noted that so far, the 28-day process time had been met;

·       Whether there was an appeals process and what percentage were accepted for continuing healthcare.  The Committee noted that there was an appeals process for the checklist stage.  Unfortunately, the percentage accepted was not a figure available at the meeting;

·       Whether the access to NHS continuing healthcare was fair and equitable.  The Committee was advised that the CCG had reviewed their process over the last three years to ensure that the process was fair and equitable;

·       Whether the demand for NHS continuing healthcare was expected to increase over the next few years.  The Committee was advised as the elderly population was increasing, yes, there was an expected increased in demand for NHS continuing healthcare;

·       Clarification was given that the funding shown at the bottom of page 17 of the report pack was just NHS funding, and that Section 75 figures was what continuing health care paid to the County Council for the section 75 agreement.  In terms of cost increases, these would be expected year on year.  It was noted that there had been additional Covid-19 funding for the current year, which had supported hospital discharges.  It was noted further that funding in the coming year was likely to reduce, as there would not be as much hospital funding expended;

·       If the move to an integrated care system would have an impact.  The Committee noted that close working arrangements were already in place with County Council colleagues and other health colleagues.  It was however highlighted that there would be opportunities to look at the way services were contracted; and what more could be done to aid working as an integrated system; and

·       Discharge arrangements.  The Committee was advised that there was an assessment on discharge regarding care needs, and where those care needs were met, a full assessment would take place within 28 days.  It was noted that the assessment would determine the funding route and that the hospital discharge fund had been put in place to make the process more effective.  The Committee noted that the 28-day period would not start until the person was discharged, if required a checklist would be put in place and that would then start the 28 days.  It was highlighted that most packages of care from hospital to home went through the local authority, and it was only the most complex cases which were funded by the NHS.

The Chairman on behalf of the Committee extended his thank to the presenters.

RESOLVED

1.      That the report on NHS Continuing Healthcare be noted.

2.      That Lincolnshire Clinical Commissioning Group’s obligation to follow national guidance, as set out in National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, (revised October 2018) in its implementation of NHS Continuing Healthcare arrangements be noted.

3.      That no changes are currently proposed to the eligibility arrangements for NHS Continuing Healthcare be noted.