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How much help can you get from the NHS?

 

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Navigating the best way in which you or your loved one can get help from the NHS can be a bit daunting but your GP and your local Clinical Commissioning Groups (CCG) should be able to help.

Getting the most out of your local GP surgery is very important as they are the gateway to all health services.

  • Talk to your GP about your health issues or concerns as well as any medication or treatment you are having. While GPs are not responsible for Social Care, they can often give you good advice and can point you in the right direction.
  • Keep up a good relationship with others in the GP surgery team as they can provide great help to you.
  • If you need help with daily tasks at home, they will be able to give you a referral to an Occupational Therapist (OT). OTs are experienced professionals who can support you in finding the most appropriate equipment and can also advise you on how you might best adapt your home to be able to carry out everyday activities. See our article on ‘Equipment and Adaptations’.

NHS Continuing Healthcare is fully funded care, paid for by the NHS and administered by your local CCG. 

  • CCGs replaced Primary Care Trusts (PCT) as NHS organisations set up by the Health and Social Care Act 2012 to organise the delivery of NHS services and they are made up of local GPs and other healthcare professionals.
  • They are responsible for ‘commissioning’ – planning, designing and paying for your NHS services including hospital care, rehabilitation, most community services, general practice and mental health services.
  • Your local CCG is responsible for deciding your eligibility to Continuing Healthcare. If your needs are ‘primarily health related’ and are deemed to be complex, you may be eligible for this without undergoing the financial assessment that is undertaken in Social Care assessments. see our articles on ‘What financial help can I get for my Care and Support?’ and ‘Paying for your own care’
  • After an initial assessment by a health or social worker, utilizing the NHS Continuing Healthcare ‘checklist’, they may undertake a ‘Full assessment’ which will involve them meeting with you and others that support you. This involves them filling in a complex form called the Decision Support Tool. Their assessment will consider your needs under the following headings:
    • breathing
    • nutrition (food and drink)
    • continence
    • skin (including wounds and ulcers)
    • mobility
    • communication
    • psychological and emotional needs
    • cognition (understanding)
    • behaviour
    • drug therapies and medication
    • altered states of consciousness
    • other significant care needs
  • This will then be reviewed by the CCG and you will be informed of their decision.
    • If they say No, you can ask them to look at the information again
    • If they say Yes, they will choose someone (often called a case manager or care manager) to work with you
    • Sometimes, they will agree with Social services that they will jointly fund your care
  • There are different ways that you can have NHS Continuing Healthcare money but you may find it most suitable as a Personal Health Budget and to get it set up as a Direct payment so that you (or your advocate) can use that money to buy and manage your own care and support directly. You should be aware that NHS Continuing Healthcare money is for all your help and care not just health care. In most cases, you can elect to receive care services in your own home with a carer of your choice.  NHS funding is not mean tested and there is no financial assessment, but you should be aware that your eligibility for funding will be reviewed annually (or more frequently in certain circumstances).

There is excellent support for Mental health and Dementia in the region that you can have access to.

  • If you, or the person you care for, have concerns about your mental health your initial contact should be with your GP. They may decide what is best for you including referral to NHS Mental health services who will provide excellent assessment and treatment services.   However, due to pressures on these services, there are currently long waiting times for treatment which is not deemed to be very urgent. 
  • Services for Oxfordshire and Buckinghamshire are provided by the Oxford Health NHS Foundation Trust. In Berkshire, they are provided by the Berkshire Healthcare NHS Foundation Trust. Support includes both a community mental health team and a memory clinic. The Memory Clinic services are there to help people who are worried that their poor memory may be a sign of dementia. Waiting times for the Memory Clinic is around 8 weeks.

Further information:

CCGs

NHS Continuing Healthcare

Mental Health