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Hospital Based Complex Clinical Care


The Independent Review of NHS Continuing Healthcare, published on May 2, 2014 recommended that NHS Continuing Healthcare be completely revised, as it was no longer fit for purpose.

From June 1, 2015 NHS Continuing Healthcare will be replaced by Hospital Based Complex Clinical Care:

Why change?

The way care is being provided is changing. People want to stay in their own home, or in a homely setting for as long as possible, and receiving long-term care in a hospital should be the last resort.

Local authorities and NHS Boards have been working together over the last few years to develop services that support this, including Intermediate Care services, like reablement, hospital at home and more intensive home care services.

These services are able to support people with a high level of needs at home or in a homely setting:

New eligibility question

Assessment for long-term complex clinical care will now be based around a single eligibility question:

'Can the individual’s care needs be properly met in any setting other than a hospital?'

If, following a full assessment, the answer to this question is 'Yes' then the person will be discharged from NHS care to a suitable community setting – home with support, a care home or supported accommodation.

At this point the local authority's charging policies will apply, and the individual may have to contribute towards the cost of their care. The local authority will carry out a financial assessment, to work out how much someone needs to contribute towards care costs. Find out more:

NHS Boards will remain responsible for meeting any medical needs after discharge from hospital.

The assessment

The assessment will be carried out by the responsible consultant or equivalent specialist, informed by the Multi-Disciplinary Team. The assessment should be carried out in partnership with the patient, family or carer, and their views and wishes should be taken into account.

The assessment will help establish the best place for the person to have their clinical healthcare needs met. All options should be considered and the outcome of the process explained to the individual, their family and carer.

NHS care should be free. Why do people have to pay?

If someone has a health need then the NHS will still be responsible for meeting that need – free of charge.  However, people in care homes will be asked to contribute (subject to their financial circumstances) towards their social care and accommodation costs.

Only those who need to be in hospital will be exempt from charges relating to their accommodation. Everyone else, whatever their age or disability should contribute to the funding of accommodation costs, following a financial assessment.