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02071834884
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02071834884

Complex Care

Clients receiving complex care have substantial and ongoing healthcare needs. These can be the result of chronic illness, disabilities or following hospital treatment. Complex care is sometimes referred to as long-term care or continuing care.

Who provides complex care?

As would be expected, the NHS is the principle provider of complex care services in the UK. The NHS (through Clinical Commissioning Groups or ‘CCGs’) arranges care for complex care patients. Services are provided in various settings but, in essence, can be summarised as follows:

  • In the patient’s own home; where the NHS will either provide or fund a third party partner to provide care services based an agreed assessment of needs;
  • In a nursing home; where the patient is cared for in either an NHS residential environment
  • In a third party partner’s facility where care is paid for by the NHS.

NHS complex care is not available for every individual who has a disability or has been diagnosed with a long-term illness or condition.

Complex care is also arranged and provided by local authorities (councils) for some individuals on a ‘means-tested’ basis.

Who is eligible for NHS-funded complex care?

Eligibility for NHS-funded continuing care is normally determined by the local clinical commissioning groups (CCGs).

To be eligible for NHS Complex Healthcare, an individual’s main or primary need must relate to their health. If their primary reason for needing care relates to their health, the NHS is responsible for providing for these care needs. A complex medical condition that requires significant intervention and ongoing support is likely to be assessed as requiring complex care. This also applies to end-of-life (or palliative) care if the condition is deteriorating rapidly.

What happens if NHS-funded care in not available?

For those that are not eligible for NHS-funded care, funding may be available through the social care budget which is managed and arranged by local authorities (councils). Social care benefits are ‘means tested’ (i.e. an individual personal financial circumstances are assessed) and local authorities are permitted to charge for services they arrange or provide (or ask for a contribution to the cost).

What happens in the complex care assessment process?

Whether you’re eligible for NHS Complex Healthcare or not, if you have ongoing care needs a care planning process will decide how best to meet your needs. Your care needs will be identified, and their impact on your daily living and quality of life will be evaluated. The assessment will focus on your needs for care, not on conditions such as where your care is provided or who provides it.

As part of the process of planning your care, your eligibility for NHS Complex Healthcare or NHS-funded Nursing Care will also be assessed.

The assessment process may have two stages – an initial screening and a full assessment. However, where someone is nearing the end of their life, senior doctors or nurses may use a ‘fast track tool’, to enable care to be put in place urgently.

Having either an initial screening or a full assessment does not mean that your eligibility is likely to be confirmed.

What is complex care?

Individuals who require or are in receipt of complex care (also known as long-term care or continuing care). Trinity delivers complex care services to clients in their own homes. Clients receiving complex care have substantial and ongoing healthcare needs. These can be the result of chronic illness, disabilities or following hospital treatment.

Who provides complex care?

As would be expected, the NHS is the principle provider of complex care services in the UK. The NHS (through Clinical Commissioning Groups or ‘CCGs’) arranges care for complex care patients. Services are provided in various settings but, in essence, can be summarised as follows:

  • In the patient’s own home; where the NHS will either provide or fund a third party partner to provide care services based an agreed assessment of needs;
  • In a nursing home; where the patient is cared for in either an NHS residential environment
  • In a third party partner’s facility where care is paid for by the NHS.

NHS complex care is not available for every individual who has a disability or has been diagnosed with a long-term illness or condition.

Complex care is also arranged and provided by local authorities (councils) for some individuals on a ‘means-tested’ basis.

Who is eligible for NHS-funded complex care?

Eligibility for NHS-funded complex care is normally determined by the complex care department of local clinical commissioning groups (CCGs).

To be eligible for NHS Complex Healthcare, an individual’s main or primary need must relate to their health. If their primary reason for needing care relates to their health, the NHS is responsible for providing for these care needs. A complex medical condition that requires significant intervention and ongoing support is likely to be assessed as requiring complex care. This also applies to end-of-life (or palliative) care if the condition is deteriorating rapidly.

What happens if NHS-funded care in not available?

For those that are not eligible for NHS-funded care, funding may be available through the social care budget which is managed and arranged by local authorities (councils). Social care benefits are ‘means tested’ (i.e. an individual personal financial circumstances are assessed) and local authorities are permitted to charge for services they arrange or provide (or ask for a contribution to the cost).

What happens in the complex care assessment process?

Whether you’re eligible for NHS Complex Healthcare or not, if you have ongoing care needs a care planning process will decide how best to meet your needs. Your care needs will be identified, and their impact on your daily living and quality of life will be evaluated. The assessment will focus on your needs for care, not on conditions such as where your care is provided or who provides it.

As part of the process of planning your care, your eligibility for NHS Complex Healthcare or NHS-funded Nursing Care will also be assessed.

The assessment process may have two stages – an initial screening and a full assessment. However, where someone is nearing the end of their life, senior doctors or nurses may use a ‘fast track tool’, to enable care to be put in place urgently.

Having either an initial screening or a full assessment does not mean that your eligibility is likely to be confirmed.