Continuing Healthcare Case Study

• Circa 500 patient case reviews completed
• 280+ eligibility reassessments completed
• £6.3M financial benefit achieved

The Challenge

NHS Continuing Healthcare (CHC) is a package of care for adults aged 18 or over which is arranged and funded solely by the NHS. To receive NHS CHC funding, individuals must be assessed according to a legally prescribed decision-making process to  determine whether the individual has a ‘primary health need.’

MIAA is working with an NHS Integrated Care Board (ICB) in the northwest to provide specialist clinical resource to complete the assessment of their backlog NHS CHC case re-views.

The Outcomes

The first phase of this project completed 287 CHC Fast-Track re-assessments, 49 multi- disciplinary team led re-assessments which were required following the outcome of CHC case review recommendations, and 498 CHC case reviews. This process ensured that all patients received an appropriate care package which met their current needs.

Recommendations were made focusing on improvements in the approach to undertaking CHC reviews in a multi-organisational setting with MIAA coordinating local  authority, ICB and trusted clinical partners.

The project delivered an improved patient  experience and system efficiency with  appropriate resources used to best effect with backlogs significantly reduced. It has resulted in  total full year savings in  excess of £6.3m, which is in line with the broad estimations at the outset of the project*.  This has produced a 10 fold return on investment for the client.

The Approach 

MIAA undertook an initial baseline assessment of All Age Continuing Care cases which included;

• Generic NHS CHC (complex),
• Mental Health Act section 117,
• Fast track, and,
• Funded Nursing Care cases.

Protocols were defined and agreed to apply for data sharing, compliance with information governance requirements and engagement with all relevant stakeholders’ individuals, representatives, Integrated Care Board and relevant local authority leads. 

Following the identification of appropriate cases for review, an assessment of care requirements for each individual patient was undertaken to determine their current care need(s) and whether any significant changes were identified. As an output, an explanation of any significant change in need which required a full ‘Multi- Disciplinary Team’ assessment was completed. 

Where  a significant change in care need was  identified, a full review of the current care package was undertaken. MIAA has continued to deliver staged  programme delivery benefits for this project since 2022.

*This figure excludes savings generated from changes in packages of care re-negotiated by the client following CHC case reviews.

Contact

For more information on MIAA Solutions services and support, contact Keith Bowman, Executive Director of Solutions, Steve Warburton, Director of Delivery –  Healthcare & Transformation or Ken Jones, Director of Delivery – Finance & Corporate Performance.