You should be fully involved in the assessment and have your views taken into account. You can ask a relative or carer to help and support you throughout the process.
Most people will start by completing a checklist. This assesses your needs and indicates whether or not you should have a full assessment.
If you’re referred for a full assessment, evidence will be collected from all relevant health and social care professionals to give a full picture of your physical, mental health and social care needs.
Then a team of health and social care professionals involved in your care will look at this evidence and recommend whether or not you’re eligible. You and / or your representative can attend and participate at this meeting.
If you are eligible
The team will forward their recommendation to the Clinical Commissioning Group (CCG) that is responsible for funding your care. The CCG will then discuss and agree a care and support package with you.
This care and support package will be reviewed after 3 months and then at least every year. If your care needs change, your funding arrangements may also change.
Personal Health Budgets
If you’re eligible for NHS continuing healthcare, you have the right to a Personal Health Budget. Personal Health Budgets allow more choice and control over the services and care you receive and can be used to pay for a wider range of items and services, including therapies, personal care and equipment.
If you choose this, you will develop a care plan with your NHS team that will meet your personal health and wellbeing needs.
See NHS Choices for more information about Personal Health Budgets.
If you’re not eligible
If you’re not eligible for NHS continuing healthcare, you’ll be referred to your local authority to decide whether you’re eligible for help to arrange or pay for care.
However, you may be eligible for NHS-funded nursing care.
If you’re not happy with the decision
If you’re turned down, you should be sent a letter telling you why. It should also tell you what steps to take and who to contact if you’re unhappy with the decision.
- If you weren’t given a full assessment, you can ask the CCG to reconsider your case. If you are still dissatisfied you can use the NHS complaints system to pursue your case.
- If you’re not happy after a full assessment, you can ask for the CCG to reconsider its decision. If you are still dissatisfied, you can ask for an independent review of your case.
- If you’re not happy with any help you receive from the NHS, you have a right to complain. Details of the complaints procedure are available from the relevant organisation.
If you are approaching the end of your life, you may be eligible for ‘fast tracking’ which allows you to bypass the full assessment process mentioned above. You must have a rapidly deteriorating condition that may be entering a terminal phase.
If you’re eligible, a care package should be put in place as soon as possible, preferably within 48 hours.