Topic 2 - Responsibilities of the NHS for healthcare provision Flashcards
Before 2001, most care homes registered to provide nursing care were maintained by
Social Services
In 1999, the Royal Commission recommended that personal care should be available after assessment and paid for out of … while … should be subject to co-payment according to means.
General taxation
Housing and Living Costs
While there is no precise definition of nursing care, the general understanding is that it relates to
Treatment or prevention of illness or disability
Section 49 of the Health and Social Care Act 2001 removed local authorities’ responsibility to
Pay for nursing care in care homes
CHC and NHS funded nursing care are set out under the …
National Framework
The Health and Social Care Act 2012 represented an extensive reorganisation of the NHS. This included the establishment of … that commission most of the NHS services in the local areas for which they are responsible
Clinical Commission Groups (CCGs)
The National Framework describes continuing care as:
[A] package of ongoing care that is arranged and funded solely by the National Health Service (NHS) where the individual has been assessed and found to have a ‘primary health need’ […] Such care is provided to an individual aged 18 or over, to meet health and associated social care needs
that have arisen as a result of disability, accident or illness.
Continuing care is sometimes referred to as…
Fully funded NHS care
Care needs portrayal
document that may be completed when the MDT when assessing eligibility for NHS CHC. Used in conjunction with the DST, records a person’s care needs.
Checklist screening
light-touch assessment to identify people who may need CHC, they will then do the full assessment if necessary.
The Decision Support Tool (DST)
helps bring together and assess evidence of a persons need to see if they need CHC. Assessor may be a social care professional or local authority staff. Used during full assessment.
Multi-disciplinary team
people who carry out the full assessment for CHC. Must include at least 2 professionals from different healthcare professions. Or one HC professional and one SC professional.
Eligibility process has 2 stages:
- Initial screening – nurse, doctor or other H or S care professional
- Full assessment – Multidisciplinary team using a DST
DST looks at the following care domains:
- Behaviour
- Cognition (understanding)
- Psychological/emotional needs
- Communication
- Mobility
- Nutrition
- Continence
- Skin and tissue visibility
- Breathing
- Symptom control through drugs and medication
- Altered states of consciousness (coma)
- Other significant care needs
The DST measures the need of each domain through the following ratings:
None, low, moderate, high, severe priority
What are the rules surrounding patient consent with the DST
They must consent before any work is done, and they can withdraw their consent at any time
The DST is a tool solely to support the decision making, but what team must make the final recommendation
Multidisciplinary team
In most cases, it should take no more than … from being referred for a full assessment to receiving a decision
Two weeks
If a patient is assessed as not eligibile for CHC, what 2 steps can the patient take
They can first ask the CCG to reconsider
If not, they can go to the NHS complaints teams
If a patient is not eligible for CHC, they can be potentially put forward for…
NHS funded nursing care
How long should the first review take place after being assessed as eligible for care, and how frequent are the reviews after that
3 months
At least once a year
When did the standard band of NHS funded nursing care come into play?
October 2007
What are RNCCs?
Registered nursing care contributions - the pre October 2007 bands of NHS funded nursing care.
What were the three bands of RNCCs?
Low, medium and high
What has happened to patients who were on the highest RNCCs band pre 30 September 2007
They have stayed on the high band on care contributions unless they are assessed as needing other levels of care.
Where the costs of nursing care are not covered by the NHS, then …. will meet the shortfall
the local authority (subject to means testing) or the individual
What are the key points of nursing care contributions in Scotland?
If people are living in a care home or assessed and need to be, they receive a flat rate for help. Regardless of age, paid to the patient.
What were the key points of the Coughlan Case?
Coughlan was disabled and rejected from NHS CHC.
She did not meet criteria fully, but argued that she still needed help and assistance.
People were being unlawfully charged for social care services
The Court of Appeal agreed and stated that the NHS must take care of anyone whose primary need is a health need, and social services should only assist where they are legallt allowed to
Coughlan test was introduced for fairness
Gov asked health authorities to ensure their criteria was consistent
Why did the Parliamentary and Health Service Ombudsman criticise the Department of Health following the Coughlan case?
Lack of direction, and still allowing the individual authoritites to decide who needed care, allowing for further confusion as to who is eligible
Why did the NHS turn away nursing care to Grogan?
Because her needs fell within the lower RNCCs band. They were only giving care to people in the higher RNCCs band, which made it nearly impossible to get NHS nursing care.
What conclusions did the judge make in the Grogan case?
Professionals had been led to believe assessment for nursing care was still based on RNCCs bands
The criteria was fatally flawed as the DoH had not fully implemented the Coughlan test, and the Health Authority had linked NHS nursing care eligibility to the RNCCs bands
The judge criticised the … for failing to produce clear guidance and direction to the NHS.
Department of Health
The judge in the Grogan case stressed that H&S servcies should look at …. to see whether the person is eligible for care or not.
The totality of a person’s needs
