The NHS Continuing Healthcare (CHC) Decision Support Tool (DST) has been updated, alongside new supporting guidance.
The DST is the document used by multidisciplinary teams to record an individual’s needs and make a recommendation about whether they have a primary health need and are therefore eligible for NHS Continuing Healthcare.
At Compass CHC, we have reviewed the new documentation against the previous 2022 version to understand what has changed and, importantly, what this could mean for families going through the CHC assessment process.
Read more: What is the Decision Support Tool?
Has the eligibility test changed?
The reassuring news is that the fundamental principles used to determine eligibility for CHC funding remain substantially unchanged.
The new guidance continues to require consideration of the nature, intensity, complexity and unpredictability of an individual's needs. It also retains several important principles that can be crucial when determining eligibility.
These include:
- Well-managed needs are still needs. A need should not be marginalised simply because good care and intervention are successfully managing it.
- Where, after considering all the relevant evidence, it remains difficult to decide between two levels of need, the multidisciplinary team should choose the higher level and record the evidence and any significant differences of opinion.
- Needs must be considered together, including the way needs in different care domains interact and potentially increase the complexity, intensity or unpredictability of the care required.
- Anticipated deterioration can also be relevant. In some circumstances, the guidance confirms that expected increases in need can contribute to a recommendation of eligibility before that deterioration has occurred.
So, what has changed?
One of the most noticeable changes is the structure of the documentation.
Much of the detailed guidance previously contained within the 2022 Decision Support Tool has now been separated from the DST itself and placed within standalone supporting guidance. The new DST is consequently more structured around recording the evidence and conclusions of the multidisciplinary team.
The new guidance also makes clear that the national DST should not be changed, added to or abbreviated, helping to reinforce a standardised national approach.
What does this mean if you are applying for CHC funding?
For individuals and families, the central message is that the fundamental basis upon which eligibility for NHS Continuing Healthcare is determined has not been replaced by a new test.
Louis Seymour, Legal Services Director at Compass CHC said:
“Families should feel reassured by these changes. The fundamental principles that determine eligibility for NHS Continuing Healthcare remain, but the updated approach also brings some welcome improvements, with a clearer structure around the evidence, the individual’s involvement and how the multidisciplinary team reaches its recommendation. Ultimately, the focus remains where it should be: on the individual, the totality of their needs and whether they have a primary health need.”
If you believe that you or a loved one may have been eligible for NHS Continuing Healthcare funding but did not receive an assessment, contact us for a free, no-obligation initial assessment. Our specialist advisers can explain the retrospective review process and help you decide whether to pursue a claim.
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If you think you or a loved one may be eligible for CHC funding, don’t delay. We’re here to guide you through every step.
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