Continuing NHS health care services,

as a result of a disability, chronic illness or following hospital treatment

If you meet local eligibility criteria, you may receive services in a variety of locations - in hospital, at home, in a care home, in a day hospital or day centre or in a hospice. Government guidance stresses that the setting of care is not the sole or main determinant of eligibility for continuing NHS health care.

Services may include:

• fully funded continuing NHS health care in a care home or other setting;
• rehabilitation and recovery services;
• palliative care;
• respite health care;
• specialist health care support;
• specialist health care equipment;
• specialist transport.

Fully funded continuing NHS health care in a care home or other setting

If you are assessed as having a need for accommodation and personal care but your primary need is for health care, your care will be the responsibility of and be funded by the NHS.

In many instances, this care is provided in a care home and all costs -accommodation, personal care and nursing care - are the responsibility of the PCT (Primary Care Trust). However care may be provided in a care home providing nursing care, a hospital, a hospice or at home.

Rehabilitation and recovery services

Rehabilitation and recovery services should be able to promote your recovery and maximise your independence and may be offered if you have undergone major surgery, suffered a heart attack, a stroke or an acute episode of a long-term illness. Services may continue for weeks or months and may include speech therapy to help with speech or swallowing, physiotherapy to help with mobility or dexterity or occupational therapy to identify and promote proficient use of suitable aids and home adaptations. It may also include a period of recovery after acute hospital treatment to help you regain your confidence about going back home.

Intermediate care is intended to fill a similar role but is strictly time limited.

Palliative care

This term is used to describe care by a multi-professional team. It is designed to support you (and your family) when a life-threatening disease no longer responds to treatment. Palliative care services are designed to keep you comfortable and ensure the best quality of life for you and your family. They may therefore include controlling and managing pain and other physical symptoms.

Providing emotional support during and following an illness are important components of such care. See section useful organisation for details of charitable organizations that can provide support to terminally ill cancer patients and their families.

Respite health care

Respite health care describes a period of care for someone who is normally cared for at home, usually by a relative or close friend. It may be provided when their usual career is ill or to give the carer a break.

If you do not meet the local PCT’s eligibility criteria for respite health care, respite care can still be arranged by the local authority. In this instance you may be asked to pay towards this care. If the local authority is asking you to pay towards the cost of respite care and arranges your care in a nursing home, the NHS should take responsibility for paying for the nursing care element of your stay. The NHS must also arrange and fund an adequate level of respite health care, particularly for those who during a period of respite care require or could benefit from active rehabilitation.

Crossroads, a voluntary, charitable organization, can also help arrange respite care - domiciliary rather than residential - either with or without involvement of social services. You may be asked to pay for this service. See “useful organisation” for contact details and to see if they offer a service in your area.

Specialist transport

Ambulances or other forms of specialist transport may be used, if your medical condition requires it, to access specific health care treatment. This may include:

• transport to and from a hospital or hospice;
• transport where an emergency admission is being made to a care home;
• non-emergency transport to and from health care facilities for people living at home or in a care home.

Such transport is likely to be approved and organised by a healthcare professional involved in your care.

Specialist health care support and equipment

Other services which you are entitled to receive free of charge, if you are assessed as needing them include:

• occasional continuing specialist medical advice or treatment;
• specialist care such as continence advice, stoma care, diabetic advice or community services such as physiotherapy, speech and language therapy and chiropody;
• continence pads, relevant equipment and nursing aids;
• a range of community equipment services including commodes, pressure sore redistribution equipment;
• specialist medical and nursing equipment such as specialist feeding equipment not available on prescription and normally only available through hospitals.

On-going need for primary care and community health services

Regardless of where you live, you will need to see a GP at some time and may need other community health services such as a dentist or optician.

You should be registered with a GP practice and receive the same services in a care home or sheltered housing as you received when living in your own home. There should be no extra charge for these services in these settings. You should also have access to a dentist or optician. If for health reasons you are unable to visit their premises, there should be no additional charges made for a home visit. In some cases, you may need to visit their premises in order to access specialist equipment.

Note: ‘NHS funded registered nursing care or intermediate care may be options for someone with continuing health needs. They do not fall within the category of continuing NHS health care services.

Useful organisations

Commission for Social Care Inspection (CSCI), 33 Greycoat Street, London SW1P 2QF, helpline 0845 015 0120 (local call rate), website: www.csci.org.uk. CSCI (may be referred to as “see-sky) is responsible for registering and inspecting care services including care homes in England. You can complain to the Commission if you are unhappy with the care being provided in a care home. If you contact the helpline, it will be able to give contact details of the office responsible for homes in your area.

The Healthcare Commission, Finsbury Tower, 103-105 Bunhill Row, London EC1Y 8TG, tel: 020 7448 9200, website: www.healthcarecommission.org.uk Email: [email protected] The Healthcare Commission is the regulator for NHS, private and voluntary healthcare in England.

Their website explains their wide range of responsibilities to improve the quality of healthcare in England. It also contains reports produced as a result of reviews of local NHS services; patient surveys and star ratings for NHS organizations.

Health Service Ombudsman, Millbank Tower, Millbank, London SW1P 4QP, tel: 020 7217 4051, enquiryline: 0845 015 4033 (local call rate), website: www.ombudsman.org.uk. Reports published by the Ombudsman can be read in full on the website or purchased by calling the enquiry line.

NHS Direct, 0845 46 47 (local call rate) is the 24 hour NHS helpline. It can give details on areas covered by each SHA and PCT in England. It can also give details of the NHS complaints procedure and contact details of your local Patient Advice and Liaison Service (PALS).

Office of Fair Trading, Fleetbank House, 2-6 Salisbury Square, London EC4Y 8JX, tel: 020 7211 8000, consumer helpline 08457 22 44 99 (local call rate), website: www.oft.gov.uk. The booklet Fair Terms for Care can be ordered by writing to OFT PO Box 366, Hayes UB3 1XB or by calling 0870 60 60 321 (national call rate).

Hospice Information, Help the Hospices, Hospice House, 34-44 Britannia Street, London WC1X 9JG, tel: 0870 903 3 903 (national call rate), website: www.hospiceinformation.info/index.asp. Hospice information is a partnership between St Christopher’s Hospice and Help the Hospices and offers an enquiry service to the public and professionals on UK and international palliative care.

Macmillan Cancer Relief, 89 Albert Embankment, London SE1 7UQ. Cancerline 0808 808 2020 (free call), website: www.macmillan.org.uk. Macmillan can provide expert support in the form of Macmillan nurses and other health professionals. It has a patient’s grants service and can also provide information and emotional support through Cancerline, its free phone helpline.

Marie Curie Cancer Care, 89 Albert Embankment, London SE1 7TP, tel: 020 7599 7777, website: www.mariecurie.org.uk. Marie Curie Cancer Care provides help for cancer sufferers and their families in their own homes and through their hospices across the United Kingdom. Through the Marie Curie Cancer Institute it is involved in furthering knowledge about cancer and its causes.

Crossroads - Caring for Carers, 10 Regent Place, Rugby, Warwickshire CV21 2PN, tel: 0845 450 0350 (local call rate), website: www.crossroads.org.uk. This is a carer led scheme with over 200 independent Crossroads schemes throughout Englandand Wales.

They can provide practical respite care by providing a trained care attendant to take the place of the regular family carer. This could be for as little as a one hour per week or could include overnight stays or holiday respite. The range of services provided by each scheme will depend on local need and the funding available.