This document provides information about personal health budgets and continuing healthcare. It begins with an overview of personal health budgets, including findings from a national pilot that showed benefits for quality of life, wellbeing and cost effectiveness. The document then discusses the case of "Dave", who has multiple sclerosis and received a personal health budget, and how it improved his independence, care consistency, social activities, pain control and more. It also provides details on the process for personal health budgets and continuing healthcare assessments and eligibility. Breakout session examples discuss cases and whether individuals would qualify for continuing healthcare assessments.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Mental Health and Addictions Services relocated one staff position to the primary health site in Meadow Lake to be able to provide just in time service to patients who may need information, support, brief intervention or a referral for more in depth services.
Better Health
Mary Rowland; Annette Viljoen
Perspectives from northern ireland – development of bereavement care standard...Irish Hospice Foundation
Presentation delivered at the Hospice Friendly Hospitals Acute Hospital Network meeting on November 15 by the HSC Bereavement Network (HSCBN) Northern Ireland.
Health Care Consent, Aging and Dementia: Mapping Law and Practice in BCBCCPA
In October 2016, the Canadian Centre for Elder Law working with ASBC started a 16 month project on the law and practice around health care consent in BC with a focus on older adults and adults with dementia. This project will address issues around health care consent with a focus on older adults and adults with dementia. Along with addressing the legal framework surrounding health care consent it will highlighted related issues such as polypharmacy, etc.
Presented by:
- Krista James, National Director, Canadian Centre for Elder Law
- Alison Leaney, Provincial Coordinator, Vulnerable Adults Community Response, Public Guardian and Trustee
- Barbara Lindsay, Director, Advocacy and Education
The concept of advance care planning outlined. The Assisted Decision Making (Capacity) Act 2015. Using Think Ahead as a tool to engage with advance care planning and with advance healthcare directives
A care home 'is' someone's home, one day it could be yours too … best practice in end of life care in care homes. Presentation from Eleanor Sherwen, Elaine Owen and Caroline Flynn from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Mental Health and Addictions Services relocated one staff position to the primary health site in Meadow Lake to be able to provide just in time service to patients who may need information, support, brief intervention or a referral for more in depth services.
Better Health
Mary Rowland; Annette Viljoen
Perspectives from northern ireland – development of bereavement care standard...Irish Hospice Foundation
Presentation delivered at the Hospice Friendly Hospitals Acute Hospital Network meeting on November 15 by the HSC Bereavement Network (HSCBN) Northern Ireland.
Health Care Consent, Aging and Dementia: Mapping Law and Practice in BCBCCPA
In October 2016, the Canadian Centre for Elder Law working with ASBC started a 16 month project on the law and practice around health care consent in BC with a focus on older adults and adults with dementia. This project will address issues around health care consent with a focus on older adults and adults with dementia. Along with addressing the legal framework surrounding health care consent it will highlighted related issues such as polypharmacy, etc.
Presented by:
- Krista James, National Director, Canadian Centre for Elder Law
- Alison Leaney, Provincial Coordinator, Vulnerable Adults Community Response, Public Guardian and Trustee
- Barbara Lindsay, Director, Advocacy and Education
The concept of advance care planning outlined. The Assisted Decision Making (Capacity) Act 2015. Using Think Ahead as a tool to engage with advance care planning and with advance healthcare directives
A care home 'is' someone's home, one day it could be yours too … best practice in end of life care in care homes. Presentation from Eleanor Sherwen, Elaine Owen and Caroline Flynn from England's National End of Life Care Programme as part of the Department of Health's QIPP end of life care workstream seminar series at Healthcare Innovation Expo 2011
Person Centered Care through Integrating a Palliative Approach: Lessons from ...BCCPA
Aging adults are entering residential care facilities with more advanced disease than in the past and their length of stay is shorter. Most health care providers in these facilities do not receive targeted education and training in palliative care, nor are they confident to have crucial conversations about goals of care and end of life challenges with residents and their families. Due to limited capacity to manage predictable symptoms related to end of life and insufficient planning, many residents are transferred to hospital in crisis and die in the Emergency Department or acute care wards.
This presentation will showcase some of the initiatives by identifying common themes, unique features of each and strategies for success. Opportunity will be given for delegates to ask questions and brainstorm how lessons learned from these initiatives could inform the care provided at their own facility.
Presented by:
- Jane Webley, RN LLB Regional lead, End of Life, Vancouver Coastal Health (EPAIRS and the Daisy project)
- Dr Christine Jones, Island Health (SSC project: Improving end of life outcomes in residential care facilities: A palliative approach to care)
- Kathleen Yue, RN, BSN, MN, CHPCN (c) Education Coordinator, BC Center for Palliative Care
Seniors Quality Leap Initiative: Using Data to Drive Improvements in Resident...BCCPA
The Seniors Quality Leap Initiative (SQLI) is collaborative of 12 nursing homes across Canada and US whose vision is to become North Americas leading provider consortium for benchmarking clinical quality standards. The presentation will share the methods used (both the key success factors and challenges) to administer the survey to residents in long term care and how the results are being used within each SQLI organization to drive improvements.
Presented by: Jo-Ann Tait, Program Director, Elder Care and Palliative Services, Providence Health Care
Lt c year of care commissioning early implementer site workshop 5 october 2015NHS Improving Quality
Care Coordiation and service change evaluation were key themes at the LtC year of care Commissioning Early Implementer site workshop earlier this week – view the full slide set from the day.
How Do Front line Workers Provide the Four Cs of CBNC?
Contact with newborns, case identification, care and completion of treatment. A qualitative Study.
June 2015
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘...NHS Improving Quality
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘Making Measurement Better’ How well things are going and how to make it better’ presented by Sean Manning, NHS England
MS nurses skills development workshop - Emma Matthews and Liz WilkinsonMS Trust
Aims:
To provide some practical tips to managing communication & consultations effectively
How to keep on top of the admin!
How and what to audit
How to develop and maintain being a specialist
Where to find support
Person Centered Care through Integrating a Palliative Approach: Lessons from ...BCCPA
Aging adults are entering residential care facilities with more advanced disease than in the past and their length of stay is shorter. Most health care providers in these facilities do not receive targeted education and training in palliative care, nor are they confident to have crucial conversations about goals of care and end of life challenges with residents and their families. Due to limited capacity to manage predictable symptoms related to end of life and insufficient planning, many residents are transferred to hospital in crisis and die in the Emergency Department or acute care wards.
This presentation will showcase some of the initiatives by identifying common themes, unique features of each and strategies for success. Opportunity will be given for delegates to ask questions and brainstorm how lessons learned from these initiatives could inform the care provided at their own facility.
Presented by:
- Jane Webley, RN LLB Regional lead, End of Life, Vancouver Coastal Health (EPAIRS and the Daisy project)
- Dr Christine Jones, Island Health (SSC project: Improving end of life outcomes in residential care facilities: A palliative approach to care)
- Kathleen Yue, RN, BSN, MN, CHPCN (c) Education Coordinator, BC Center for Palliative Care
Seniors Quality Leap Initiative: Using Data to Drive Improvements in Resident...BCCPA
The Seniors Quality Leap Initiative (SQLI) is collaborative of 12 nursing homes across Canada and US whose vision is to become North Americas leading provider consortium for benchmarking clinical quality standards. The presentation will share the methods used (both the key success factors and challenges) to administer the survey to residents in long term care and how the results are being used within each SQLI organization to drive improvements.
Presented by: Jo-Ann Tait, Program Director, Elder Care and Palliative Services, Providence Health Care
Lt c year of care commissioning early implementer site workshop 5 october 2015NHS Improving Quality
Care Coordiation and service change evaluation were key themes at the LtC year of care Commissioning Early Implementer site workshop earlier this week – view the full slide set from the day.
How Do Front line Workers Provide the Four Cs of CBNC?
Contact with newborns, case identification, care and completion of treatment. A qualitative Study.
June 2015
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
Living as Well as you Can for As Long as you CanBCCPA
Sit down buffet breakfast featuring keynote speaker Dr. Romayne Gallagher, Head Division of Palliative Care, Department of Family & Community Medicine, Providence Health Care; Clinical Professor, Division of Palliative Care, UBC
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘...NHS Improving Quality
Transforming End of Life Care in Acute Hospitals PM Workshop 3: Vital Signs ‘Making Measurement Better’ How well things are going and how to make it better’ presented by Sean Manning, NHS England
MS nurses skills development workshop - Emma Matthews and Liz WilkinsonMS Trust
Aims:
To provide some practical tips to managing communication & consultations effectively
How to keep on top of the admin!
How and what to audit
How to develop and maintain being a specialist
Where to find support
Abnormal mental states and behaviours in MSMS Trust
Learning outcomes:
Recognition and treatment of depression and anxiety in MS
Recognise sudden changes in emotional state (laughter, crying, anger)
Recognition of mania and psychosis in MS
Cognitive impairment
Treating virtual symptoms Functionality in MS - Wojciech PietkiewiczMS Trust
Objectives:
To be able to tell with good probability what is organic and what is not in your MS patient
To be able to understand where non-organic problems come from
To be able to tell the diagnosis to the patient
To know how to approach the condition
To make sense of the idea of psychosomatic disease
Prescribing, administration and supply of medicines by allied health professi...MS Trust
This presentation by Helen Marriott, AHP Medicines Project Lead, looks at prescribing and medicines supply mechanisms and the AHP Medicines Project.
It was presented at the MS Trust Annual Conference in November 2014.
Patient activation: New insights into the role of patients in self-managementMS Trust
This presentation by Helen Gilburt, Fellow at The King's Fund, looks at why some people are active at managing their health while others are quite passive, and how levels of patient activation impact on health outcomes.
It was presented at the MS Trust Annual Conference in November 2014.
This presentation by Gail Clayton, Lead MS Clinical Nurse Specialist and Jacki Smee, MS Clinical Nurse Specialist at Cardiff and Vale University Health Board explores setting up an Alemtuzumab service. It includes: patient selection, infusion related and long-term side-effects, ongoing monitoring requirements, potential challenges and case studies.
It was presented at the MS Trust Annual Conference in November 2013.
This presentation by Gavin Giovannoni looks at the new treatment paradigm for MS. It includes: arguments for early treatment in multiple sclerosis, the effect of MS on quality of life and whether highly-effective treatments stabilise MS.
It was presented at the MS Trust Annual Conference in November 2013.
Michelle Pilling, Lay Member Patient and Public Involvement and Deputy Chair with Dave Rogers, Head of Communications & Engagement at East Lancashire CCG
How can front-line professionals incorporate the emerging brain health ...SharpBrains
(Session held at the 2014 SharpBrains Virtual Summit; October 28-30th, 2014)
12:30-2pm. How can front-line professionals incorporate the emerging brain health toolkit to their practices?
- Elizabeth Frates, Director of Medical Student Education at the Institute of Lifestyle Medicine
- Dr. Catherine Madison, Director of the Ray Dolby Brain Health Center at California Pacific Medical Center
- Barbara Van Amburg, Chief Nursing Officer at Kaiser Permanente Redwood City
- Dr. Wendy Law, Clinical Neuropsychologist at Walter Reed National Military Medical Center
- Chair: Dr. Michael O’Donnell, Editor-In-Chief of the American Journal of Health Promotion
Learn more here:
http://sharpbrains.com/summit-2014/agenda/
Advancing Team-Based Care: Achieving Full Integration of Behavioral Health an...CHC Connecticut
This webinar highlighted ways to fully integrate behavioral health care into primary care. The role of nurses, medical assistants, behaviorists, lay health workers, and primary care providers was discussed along with the use of clinical dashboards and warm hand-offs.
This webinar was presented May 19, 2016 3:00 p.m. Eastern Time
How to Build Your Mitochondrial Medical Homemitoaction
Topics include:
The importance of a medical home for a mitochondrial disease patient.
Definition of a medical home.
How to establish a medical home.
Why a medical home is an important component of good patient advocacy.
Tips on maintaining a healthy medical home relationship.
Wees will describe theses issues primarily from a pediatric perspective, but she will give adult examples as well.
Wees is a patient advocate with Empowered Medical Advocacy. She assists parents and caregivers each week in navigating toward improved quality of life for their child and their families.
Implementing Post-Graduate Nurse Practitioner and Clinical Psychology Residen...CHC Connecticut
In this final webinar of the Training the Next Generation series, we featured successful postgraduate nurse practitioner and psychology residency programs from around the country. Each presenter shared their unique experiences, successes, and failures of implementing these programs at their health centers.
Transforming End of Life Care in Acute Hospitals PM Workshop 5: How to use th...NHS Improving Quality
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Improving Discharge Care for Children with Special Health Care Needs through...LucilePackardFoundation
Being discharged from the hospital is a vulnerable time for families and caregivers of children with special health care needs (CSHCN). Appropriate resources and support are essential for care at home and can prevent complications or readmission. The California-based Nurse-led Discharge Learning (CANDLE) Collaborative brings together interdisciplinary clinicians to improve discharge care delivery for CSHCN. Learn about two new discharge practices: closed-loop medication reconciliation and tailored medication teaching, and multidisciplinary discharge rounds with early discharge notification. Speakers share how these innovative practices can be integrated into existing clinical workflows.
How to make care and support planning a two-way dynamic - presentation from webinar held on 1 October 2014
This relates to the first NHS IQ Long Term Conditions Improvement Programmes Wednesday Lunch & Learn Webinar Series. How to make care and support planning a 2 way dynamic hosted by Dr Alan Nye & Brook Howells from AQuA. This webinar discussed how to encourage patients, carers and the public to work alongside (in equal partnership) with clinicians and managers
Slides from a lunch and learn webinar hosted by NHS England's Long Term Conditions Team, on the topic of health coaching by lay professionals.
The speakers and Anya de Longh and Jim Phillips.
Learning Disabilities: Share and Learn WebinarNHS England
Topic One: Enhanced Care Service (ECS)
Guest speakers: Caroline Kirby - Interim Lead Complex Needs Commissioner, Angie Simmons - Team Leader, Enhanced Care Service (ECS), Ted Page - Behavioural Nurse Specialist (ECS)
and Rachel Barrett – Expert by Experience, Speakeasy Now
The presentation reflects on good practice around avoiding hospital admission in Worcestershire who have developed an enhanced care service working proactively in the community.
Topic Two: Strategic resettlement, personalisation at scale and pace
Guest speaker: Pól Toner, Head of Improvement, NHS England
The presentation considers Strategic Resettlement, which is part of the Improvement and Enablement function of the Learning Disability Programme. It is being put in place to support the delivery of a transformational change to close inpatient services and develop the appropriate scale of personalised community care for people with a learning disability and/or autism who display behaviour that challenges, as set out in Building the Right Support. The function provides additional support to local systems to accelerate discharges where appropriate, focusing specifically on patients with the most complex needs and a long length of stay (over 5 years).
This workshop brought together, for the first time, the pioneers and the partner organisations of the Integrated Care and Support programme. It focused on building a learning community that will help develop, share and spread knowledge and solutions at scale and pace across the country.
More information: http://www.nhsiq.nhs.uk/news-events/events/integrated-care-and-support-pioneers-inaugural-workshop.aspx
More about the integrated care and support pioneers programme: http://www.nhsiq.nhs.uk/7862.aspx
Enhancing the quality of life for people living with long term conditions.
https://mhealthinsight.com/2016/06/27/join-us-at-the-kings-funds-digital-health-care-congress/
iHV regional conf: Theresa bishop - Strengthening Health Visiting into the fu...Julie Cooper
Presentation by Theresa Bishop at the Institute of Health Visiting Regional Professional Conferences 2015.
Theresa Bishop is Professional Lead for Health Visiting for Warwickshire.
Similar to Personal Health Budgets and Continuing Healthcare (20)
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
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1. Enlist the non-respiratory functions of the respiratory tract
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4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
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2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
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June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
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- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
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- GENE THERAPY
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- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
1. Personal Health Budgets and Continuing
Healthcare
Gill Ruecroft, Commissioning Manager PHB/CHC
gill.ruecroft@neneccg.nhs.uk 01604 651121
Debbie Quinn QN, MS Specialist Nurse
Northamptonshire Healthcare NHS foundation Trust
Follow this link for the Northamptonshire PHB DVD, patients and staff describing their
experience and the benefits of PHBs www.neneccg.nhs.uk/personal-health-budgets
2. Aims and Objectives
• To provide attendees with an overview of
PHB’s
• To demonstrate effectiveness of PHB’s
through case studies
• To provide attendees with an overview of CHC
funding
• To provide attendees with an opportunity to
discuss cases and share ideas
3. Plan for the session
• Gill - Overview of PHBs, national and local
implementation, learning from pilot
• Debbie – clinicians experience of a patient
with a PHB
• Gill & Debbie – All about CHC, eligibility,
process
• Break out sessions – how could this work in
practice?
4. What is a Personal Health Budget (PHB)?
A personal health budget makes it
clear to a person and the people who
support them how much money is
available for their health care so they
can discuss and agree the best way
to spend it.
5. PHB Pilot – National Evaluation Findings
• PHBs improved people’s quality of life and wellbeing
• Benefits more marked where;
o There were higher levels of need
o Higher value budgets
o People had most choice and control, least restrictions
• PHBs are cost effective, particularly for CHC and MH
• Reduction in inpatient costs
• Reported positive impacts for carers and family members
• Reported changes in relationships with health
professionals
6. National Policy for PHB roll out
In November 2012 the government announced that from April
2014, people receiving NHS Continuing Healthcare and families
of children receiving continuing care, will have the right to ask
for a personal health budget.
On 9 October 2013 Care and Support Minister Norman Lamb
announced that from October 2014 this right will be
strengthened and will become a right to have a personal health
budget.
Norman Lamb has also described that from 2015 the
government want to see PHBs available for more people with
LTCs
7. Meet Dave
Dave has MS and is eligible for CHC funding. He lives with his partner who,
with his mother, provide him with quite a lot informal care. He has a supra
pubic catheter and a voice amplifier
Measurable Outcomes from the Dave’s PHB plan:
• To improve my independence
• To improve the consistency and quality of my care
• To increase my opportunities for social interaction/activity
• To have better control of my bladder spasms
• To reduce my pain
8. Is Dave making progress?
• I feel better cared for, better looked after
• I don’t think we have completely eradicated all my pain but it is
much easier to control now
• I have definitely got more independence, definitely, I have got
more control
• Having Paul coming in every morning makes a huge difference
than waiting for carers to come from Kettering or Northampton
• This PHB has had a knock on effect on my kids, I am less angry
and they are here quite a bit
• Now I am a lot more chilled and relaxed
9. PHB High Level Process
1. Patient Identification 2. Assessment
3. Indicative Budget
4. Personal Planning
7.Monitor/recalibration
5. Agreement 6.Managing the money – ‘contract’
10. Things we learnt from the PHB pilot
• Most patients/representatives do understand PHBs
• Hard to identify and release indicative budgets
• Most people are very responsible with the money
• It is easier than we thought to identify measurable outcomes
• Important to focus on outcomes not on what they are buying
• The personal plan is the key to the best results
• Patients must be involved in the design of the processes/systems to
get them right
• Tension – current provision/decommissioning to release savings
• This is much more complex and much harder to implement than we
envisaged!
11. Clinicians Experience Case Study
• Daisy, 46 years old with progressive MS
• Nursed in bed
• Severe ataxia
• Parents carry out a lot of care with agency
support
• Frustrated with limitations of agency and
changing staff
• 2 weeks holiday a year from 25% SC&H funding
13. The CHC PHB option
• Changed to 100% CHC funding
• Parents wishing to employ own team of carers with
their support to have consistency for daughter
• Could incorporate well being – hair, nails
• Allow freedom for parents and respite at home
• Care provided around needs and wishes
14. Options for clinicians
• Smaller packages – look at shared carer
options
• Flexibility with arrangements
• More hours to attract future carers
• Enhanced care provided by carers who know
clients
• Choice
17. What is Continuing Healthcare (CHC)?
NHS Continuing Healthcare is an ongoing
package of health and social care that is
arranged and funded solely by the NHS where
an individual is found to have a ‘primary health
need’. Such care is provided to an individual
aged 18 or over, to meet needs that have arisen
as a result of disability, accident or illness.
18. Some facts
• Northamptonshire has a population of around
700,000
• At any one time there will be approx. 650
people eligible
• 150 of these will be fast track – i.e. end of life
• This equates to in the region of 0.1% of the
population being eligible for CHC funding
19. Primary Health Need
• A primary health need is not about the reason
why someone requires care or support, nor is it
based on their diagnosis; it is about their overall
actual day-to-day care needs taken in their
totality
• It is the level and type of needs themselves that
have to be considered when determining
eligibility for NHS continuing healthcare
20. Assessment and decision making
To determine that the care required is more than the limits of
the Local Authority’s responsibilities:
•Nature – characteristics and type of need
•Intensity – extent, severity and continuity (ongoing needs)
•Complexity - skills required to monitor, treat and/or manage
the care
•Unpredictability - the degree to which needs fluctuate or
deteriorate and the challenges in managing them
21. Delivery of NHS CHC
National Framework for NHS Continuing
Healthcare and NHS-funded Nursing Care
November 2012 (Revised)
National tools:
•CHC checklist (screening tool)
•Decision Support Tool (DST)
•Fast track pathway tool (End of life)
https://www.gov.uk/government/publications/national-framework-for-nhs-continuing-healthcare-and-
22. Decision Support Tool (DST)
• Supports/facilitates a full assessment for eligibility NHS
continuing healthcare
• A comprehensive multidisciplinary assessment of a person’s
health and social care needs and their desired outcomes
• The person is given every opportunity to participate in the
assessment, plus the option of being supported by an advocate
• Existing specialist assessments are used and/or referrals made
for other specialist assessments where appropriate
• Unless there are valid or unavoidable reasons, time from
checklist to funding decision will not exceed 28 days
• 12 domains/areas of need + nature, intensity, complexity,
unpredictability
23. CHC – a clinicians guide
• ‘Specialist care’
• Primary health needs
• Intense, complex and unpredictable
• Utilise Community services –
Communicate
• Family/home situation
• Checklist
24. Examples
• Pressure sores – due to severe spasticity,
requiring regular monitoring and position
changes
• Swallowing – choking, monitoring, cough
assist
• Mood – high levels of changes, loss of
consciousness, awareness
25. Examples
• If only one of the example domains is met
then CHC may fund some of a care package
jointly with Social Care and Health (i.e. 50/50)
• If more of the domains are met this could lead
to a package being offered by CHC
26. Process – clinicians guide
• Checklist
• Assessment - invitation can take 3 hours
• Involvement of all MDT – evidence
• Decision making – outcome
• Reviews
28. Break out session 1
• John is 65 years old, he has progressive MS
and is cared for by his wife. He is a wheelchair
user. His wife assists with his personal care.
He has mild spasticity, occasionally chokes on
dry foods and all pressure areas are in tact.
• Does John require a CHC assessment and if so,
why?
29. Break out session 2
• Diane is 40 years old, has secondary
progressive MS and is cared for by her
family members with a small social care
package. She has a PEG insitu, is cared for
in bed and has contractures. She has a
grade 3 sacral sore, has frequent UTI’s and
aspiration pneumonia.
• Does Diane require a CHC assessment and
if so on what grounds?
30. Other options!
Think of both the cases discussed and discuss
how a personal budget (PB) from either social
care or health could benefit each person
Editor's Notes
Debbie
Debbie
Gill
Gill
Gill
Gill
Gill
Gill
Gill
Debbie
Debbie
Debbie
Debbie
Debbie
Both
Gill
Gill or Debbie?
Gill
Gill
Gill
Gill
Behaviour
2. Cognition
3. Psychological and emotional needs
4. Communication
5. Mobility
6. Nutrition – food and drink
7. Continence
8. Skin (including tissue viability)
9. Breathing
10. Drug therapies and medication: symptom control
11. Altered states of consciousness
12. Other significant care needs.