To consider a briefing paper on NHS Continuing Healthcare by NHS Herefordshire Clinical Commissioning Group.

The chairperson said that the purpose of this item was for Herefordshire NHS Clinical Commissioning Group (CCG) to report on progress since NHS Continuing Healthcare (NHS CHC) was last considered by the committee on 20 September 2018; minute 15 of 2018/19 refers.  Linda Allsopp, associate director of nursing and quality, and Nikki Warman, head of CHC, were invited to introduce the briefing paper on behalf of the CCG.

The principal points of the introduction included:

i.             NHS CHC was a package of care that was funded solely by the NHS for an individual that had been assessed as having a ‘primary health need’; the associated test focused on nature, complexity, intensity and unpredictability.

ii.            There was a national framework, updated in October 2018, and the CCG’s CHC process was fundamentally a whole system approach, working with local authority colleagues in terms of assessing an individual's need and whether that goes beyond the responsibilities of the local authority.

iii.          This update focused on NHS England key performance indicators, including:

·              The target was being met in Herefordshire and Worcestershire for making a decision on eligibility within 28 days of a referral.

·              The target was being met for no more than 15% of assessments taking place in an acute hospital setting; there was an expectation that no assessments would be undertaken in this setting but fast track referral for an individual entering the terminal phase of life could be accepted.

·              The target was being met for accepting all appropriately completed fast track applications.

iv.          In line with the national framework, only when there was deemed to be a change in healthcare need would a review of eligibility take place.

v.           As part of the merger between the Herefordshire and Worcestershire CCGs, the CHC policies would be reviewed to ensure that systems were working as efficiently as possible to provide quality of service to all patients.

The chairperson drew attention to the recommendations made at the 20 September 2018 committee meeting and invited officers to provide appropriate updates:

a)           a small number of senior social workers be upskilled to ensure that there is a common understanding of the medical terminology when dealing with disputes

The assistant director all ages commissioning advised that interactions between the council and the CCG on CHC were progressing well.  The associate director of nursing and quality advised that adult social care employed social workers to work on CHC and there were positive working relationships.  The head of CHC added that the joint training of multidisciplinary teams on the national framework was being explored.

b)           the CCG be requested to commit to seeking to lift Herefordshire out of its current position of 6th from the bottom in the national CHC eligibility by 50k population and to report its progress against this commitment at a future adults scrutiny committee

c)           the CCG be called back to the committee to report on progress made against their action plan recommendations in six months’ time

d)           the CCG be requested to influence the report  ...  view the full minutes text for item 45