Continuing Healthcare Case Study

  • Circa 960 patient case reviews (standard CHC)
  • 351 pre-assessments (Fast Track)
  • 479 re-assessments (410 Fast Track, 69 Standard CHC)
  • £12.92m financial benefit achieved (recurrent)

The challenge

NHS Continuing Healthcare (NHS 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 have been working with an NHS Integrated Care Board (ICB) in the northwest to provide specialist clinical resource to complete the assessment of their NHS CHC case review backlog.

The outcomes

The project completed 351 CHC Fast-Track pre-assessments, 410 Fast-Track re-assessments, 69 multi-disciplinary team led re-assessments which were required following Standard CHC case review recommendations, and 960 Standard CHC case reviews. This process ensured that all of the patients were on the 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 the local authority, ICB and trusted clinical partners. The project delivered improved patient experience and system efficiency with appropriate resources used to best effect and backlogs reduced.

It has resulted in total full year savings of £12.92m, which has exceeded the estimates at the outset of the project. This has produced a 12-fold return on investment for the client

The approach

MIAA undertook an initial baseline assessment 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 key stakeholders (patients and their representatives, the ICB and relevant local authority leads). 

Following the identification of appropriate cases for review, an assessment of care requirements for each individual was undertaken to determine current care need(s) and whether any significant changes were identified. 

As an output, an explanation of any significant change in need which will require a full ‘Multi- Disciplinary Team’  assessment was completed. If a significant change in need is identified a full review of care package will be required. 

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. 

For more information about our services contact Ken Jones, Director of Finance & Corporate Performance Team

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