Building best practice in Continuing Healthcare Assessments

Background

A Continuing Healthcare Assessment is an appraisal of a patient’s care needs, in order to understand if they are eligible for NHS Continuing Healthcare (CHC). It is a vital step in ensuring that the right people get the right long-term support. As part of the recovery of services after Covid-19, the NHS CHC business unit developed a new process for standard CHC assessments.

The objective of this was to support the implementation of best practice to help ensure that the post-Covid backlog was worked through as efficiently as possible without compromising on quality. With that in mind, Edge Health were commissioned through the Getting It Right First Time (GIRFT) Projects Directorate @RNOH, to support with a review of the existing assessment process. The objective of this review was to identify areas of best practice and recommendations to inform the development of the new process.

Approach and research

The work was delivered over two phases. The first was an exhaustive analysis of CCG performance, including referral volumes, conversion rates, delays and eligibility. This data analysis was used for identification of CCGs who appeared to demonstrate strong or improving performance, or relatively high levels of backlog. This provided a balanced panel of CCGs who could be interviewed during the second phase of the research.

In this second phase, semi-structured interviews were undertaken with 17 CCGs, including at least two from every region. The interviews were conducted with a diverse range of representatives from each CCG, and covered their description of their current process, their experience of recovery post-Covid and opportunities for improvement.

Key findings

The work provided short- and long-term recommendations against each key phase of the CHC process and primary enablers of success:

• Referral management
• Checklisting
• Assessments & monitoring
• Digital
• Health & social care integration
• Short-term backlog management

Key process recommendations included the implementation of effective pre-screening of a backlog of cases to allow for more streamlined processing of applications and the implementation of a “trusted assessor” model for managing assessments. The report also highlighted a number of digital opportunities, including the development of a digital checklist and implementation of video assessments where appropriate.