Am I eligible for continuing healthcare?
We’re responsible for assessing NHS continuing healthcare applications for anyone registered with a GP in South West London.
To be eligible for continuing healthcare, your needs will be assessed by a team of healthcare professionals who will look at:
- what help you need
- how complex your needs are
- how intense your needs can be
- how unpredictable they are, including any risks to your health if the right care is not provided at the right time
Your eligibility for continuing healthcare depends on your assessed needs, and not on any diagnosis or condition. If you make an application, you will be fully involved in the assessment, usually alongside someone from your borough council.
If you’re eligible for continuing healthcare, we will arrange a care and support package that meets your needs, which could include support in your own home and the option of a personal health budget. Care and support can be provided in a nursing home if you need 24-hour care.
We work with you and consider your views when agreeing your care and support, as well as the place it’s provided. We also consider other things, such as safety, cost, and value for money.
Your needs will be reviewed in the first 3 months and then once each year. If your needs change then your eligibility for NHS continuing healthcare may change.
Requesting a continuing healthcare assessment
If you think you may be eligible for continuing healthcare you should speak with your GP, healthcare professional or social worker first.
Alternatively, you can contact the local continuing healthcare team in your borough.
Fast track assessment
If your health is deteriorating quickly and you’re nearing the end of your life, we may be able to process your application within 48 hours. Your healthcare professional will need to make a referral on your behalf.
NHS funded nursing care
If our assessment finds that you’re not eligible for continuing healthcare, but that you need nursing care in a care home, you’ll be offered NHS funded nursing care. This means that the NHS will contribute towards the cost of your registered nursing care.
Funded nursing care is available irrespective of who is funding the rest of your care home fees. Payments are made directly to your care home and are set each year by the Department of Health and Social Care.
Appealing a continuing healthcare decision
You can appeal if our assessment finds that you’re not eligible for continuing healthcare.
Your appeal must be made within 6 months of the initial decision, in line with our appeals policy. If you ask a solicitor, claims firm, independent advocate or other third party to act on your behalf you will have to pay their costs.
Our assessment recommendation remains in place throughout your appeal.