There are several means by which an individual in Devon may have their health needs assessed to determine whether they are eligible for funding:

Community

When an individual living in the community is identified as having a significant change in need, typically when the individual needs to go into a home with nursing care or have some level of care at home. The first point of access for an assessment would be through the relevant local area office:

• Eastern area – 01392 208366
• Northern area – 01769 575123
• Southern area – 01626 358650

Mental Health

Mental Health Services cover both bed based inpatient services and services in the community. This covers a wide range of settings, ages and illness. However, the overall process still remains the same, in that the person needs to be considered either using the Checklist Tool and if indicated the Decision Support Tool. Usually for inpatient services there is a Multi Disciplinary Team (MDT) who can do this, however in the community it may be more difficult to gather together a MDT. The person who is responsible for the patient, i.e. Care Coordinator, should ensure that the individual has access to being considered and assessed.

Learning Disabilities

The statutory learning disabilities services in Devon are integrated between health and social care, therefore, the process of considering someone is usually done on a joint agency basis. The social worker is involved with the community nurse or residential support staff in completing the Checklist Tool and if indicated the Decision Support Tool.

End Of Life Care (Palliative) and the Fast Track process

The National Framework has established a Fast Track process to assist professionals in securing End Of Life (EOL) services in a very short space of time. In order to satisfy the criteria the professional must ensure the following:

• the person has a terminal illness or diagnosis and their condition is rapidly deteriorating.

The professional filling in the Fastrack Tool must be a senior clinician. This doesn't necessarily have to be a doctor as long as the person has a confirmed diagnosis from a doctor.  Often it is a nurse in a senior position or a GP. The National Framework passed over the responsibility for procurement of end of life care from the local authority to the NHS to arrange. The CHC/FNC department will authorise the procurement of a package of care, i.e. nursing home placement or home care package, and will assist other health organisations and professionals with this process. Social care professionals will support health to carry out this function.

Multi Disciplinary Team (MDT)

A multi disciplinary team is a group of professionals from different disciplines, who have a role in contributing to an assessment of an individuals needs. This could include two health professionals, i.e. nurse, clinician or therapist, as well as a representative from social care services, i.e. a social worker, along with a family member or representative.

Receiving application

Once the Decision Support Tool is received and is adequate, any clear judgments that can be taken outside of panel will be made to ensure the care package can be put into place quickly. When the decision support tool indicates a borderline decision, or there is any complexity surrounding the case, it will go to panel for discussion and endorsement.

Role of CHC Eligibility Panel

It is the role of the Eligibility Panel to listen to the cases, to be satisfied that enough evidence is produced to make a judgment and to either endorse a recommendation or decline it with clear rationale. The panel considers eligibility only, financial decisions and procurement are done separately. NHS Devon retains the right to make the decision on eligibility.

Appeals Procedure

For disputes between individuals applying for Continuing Healthcare (CHC) and the NHS, in line with the appeals procedure, the first step for the claimant (e.g. relative, carer, advocate) is to seek a review of the decision by the original decision making body. This can be done in the form of a written appeal to the Appeals Administrator, Continuing Healthcare Team, NHS Devon, Floor 2, Main Building, County Hall, Topsham Road, Exeter, EX2 4QB. Further evidence to support an individual's case can be gathered and the case submitted again for the Panel to review. Thereafter, if an appellant remains dissatisfied with the decision, they are entitled to request a Stage 2 Independent appeal. If the appellant remains dissatisfied with the decision they are further entitled to seek independent review by Strategic Health Authority.