NHS Continuing Care

Decision Support Tool

The team will then use this information to complete a Decision Support Tool.

This looks at 12 different types of needs, including mobility, nutrition and behaviour. The 12th need is ‘Other’ helping decide on the nature, complexity, intensity and unpredictability of needs.

For a detailed breakdown of the 12 areas of need and to understand this the “Decision Support Tool” is applied. The Department of Health has a document explaining how the tool works. A document to explain a tool!

Using the assessment and Decision Support Tool information, the team will decide if your relative has a primary health need. They will make a recommendation to their Clinical Commissioning Group. This is led by GPs and other health professionals, responsible for buying and arranging patient care packages. Eventually, they decide whether your relative is eligible for care or not. The rules refer to England only, it’s slightly different in Wales.

Attend this meeting.

You can attend this meeting.  You can be with your relative during the assessment. It’s very helpful to have someone there to help them to communicate their needs and to take notes.

The decision

The NHS has 28 days to decide if someone is eligible. Retrospective payments will be made if they do qualify.

Challenging a “No” decision

It is possible to challenge a “No” decision and many successfully do.

Also, if your relative’s needs are urgent – because their condition is deteriorating rapidly due to a terminal illness, a Fast Track Tool is used instead of the Decision Support Tool to confirm eligibility. Subsequently, if your relative is found to be eligible, their funding from the NHS should be provided as quickly as possible.

What Does it Pay For?

• At home: healthcare, such as services from a community nurse or specialist therapist, and associated social care needs, such as personal care and domestic tasks, help with washing, dressing, preparing meals and shopping.
• In a care home: care home fees, including board and accommodation.

• Support for up to six weeks in a care home or at home for an older person in need of temporary care