What you told us about the NHS Continuing Healthcare process

Healthwatch Wiltshire has received feedback about NHS continuing healthcare for a number of years. Local people have expressed concerns about their experiences of accessing information, the application process and meeting the eligibility criteria. 

Back in 2019 Bath and North East Somerset, Swindon and Wiltshire (BSW) Clinical Commissioning Group (CCG) asked Healthwatch Wiltshire to work with them to develop a survey to find out people’s views and experiences of the CHC application process. The survey was to be distributed to CHC applicants drawn from across BSW.

We were due to begin this engagement early in 2020 but, due to the pandemic, it was put on hold until early 2022, when Healthwatch Wiltshire surveyed, analysed and evaluated the experience of 20 CHC applicants. 

Key findings

• Key information for people applying for CHC is in an NHS leaflet that many people do not receive.
• The majority of applications are made by someone other than the person whose eligibility is assessed.  
• People generally prepare very carefully for the assessment, researching eligibility criteria and gathering evidence of need.
• Some applicants find the process complicated and challenging.
• The application process is made easier for people if a social worker assists them, ideally in the initial stage of the application. 
• Applicants who meet the eligibility criteria tend to be people who understand the terminology and the role played in the assessment process by the Decision Support Tool.
• Applicants who do not meet the eligibility criteria may complain of not being treated fairly and question the overall process.
• A clear theme was the need for better liaison between CHC teams and care providers, particularly when a change of care setting is required – for example when a person is moving to a care home.
• People thought staff were professional, empathetic and supportive.