Continuing care is a two-step process. The first stage is a referral and the second stage is a full assessment for continuing care.

Continuing care referral

Your child or young person’s NHS health practitioner or social worker will consider whether it is appropriate to refer your child or young person to NHS Dorset for an assessment. They will complete a referral form to NHS Dorset. Before a referral is made the process should be discussed with you and you should be provided with the public information leaflet produced by the Department of Health and Social Care.

As part of the referral a consent form will be completed. The person with parental responsibility will usually be asked to give consent to the sharing of information. However, in some circumstances a child under 16 can consent and your child’s health or social care practitioner will assess at the time whether this is the case. There are different arrangements for young people over 16 as they are presumed to have the ability to consent unless assessed otherwise. If you would like further information about how we use and share your data please visit our information and sharing page.

On receipt of the referral NHS Dorset will review the referral and decide whether a full assessment is needed. Depending on the outcome of this review, you will either be told that your child or young person does not meet the criteria for an assessment for continuing care, or NHS Dorset will arrange for a full assessment. If your child or young person is referred for a full assessment this does not mean they are eligible, only that a full assessment should be completed.

NHS Dorset will arrange an appointment to complete the full assessment. NHS Dorset is required to make a decision about eligibility for continuing care within six weeks of accepting the referral and confirming that a full assessment for continuing care is needed. Your appointment date will reflect this in order that the full assessment can be completed within the six weeks. If you are unable to make this appointment, we would ask that you discuss this with us as soon as possible.

Continuing care full assessment

The referral will be allocated to a nurse within the Personal Health Commissioning Team who will work closely with children’s social care and any other health practitioners involved in your child or young person’s care to obtain up to date information regarding their needs. If your child or young person is at school, we will also work with the school.

Seven key things to know:

  • The assessment will involve contributions from a range of professionals. As part of the eligibility consideration for continuing care, your child or young person’s needs will be considered by a multidisciplinary team

  • The multidisciplinary team is made up of health and social care professionals who are knowledgeable about your child or young person’s health needs, and, where possible, have recently been involved in your child or young person’s assessment, treatment or care

  • NHS Dorset will collate evidence from people involved in your child or young person’s care such as their GP, social worker, carer, teacher or specialist nurse to build an overall picture of their needs. The multidisciplinary team will then use the information to complete a decision support tool

  • The purpose of the decision support tool is to help the multidisciplinary team to assess your child or young person’s health needs – and so recommend whether or not your child is eligible for continuing care. As the person with parental responsibility, you should be fully involved in the assessment process and kept informed and have your views about your child or young person’s needs and support taken into account

  • NHS Dorset will make available a family views form that you can complete and return to us. This is especially important for you to return if you are unable to attend the allocated appointment time for the decision support tool to be completed

  • The multidisciplinary team will then make a recommendation to a multi-agency panel arranged by NHS Dorset as to whether or not your child or young person is eligible for continuing care. The final decision about eligibility will be made by the multi-agency panel

  • A decision about eligibility for continuing care should usually be made within six weeks of the initial referral being accepted by NHS Dorset. The Personal Health Commissioning Team will inform the person with parental responsibility in writing, with a copy of the decision support tool as soon as they can, giving clear reasons for the multi-agency panel’s decision on whether your child or young person is eligible. The Personal Health Commissioning Team will also explain how to request a review of the decision in the event you disagree

Review of the decision

You can ask NHS Dorset for a review of the eligibility decision. This needs to be done within six months from the date of the decision letter.

What happens if my child or young person is eligible for support?

If your child or young person is eligible for continuing care, the next stage is to arrange a care and support package that meets their assessed health needs.

NHS Dorset will work collaboratively with the person who has parental responsibility and consider their views along with that of the child or young person where appropriate when agreeing their care and support package and the setting where it will be provided. However, NHS Dorset can also take other factors into account, such as the cost and value for money of different options.

It can take some time to source care which is dependent on individual circumstances, this may be due to the level of care required and the availability of care in the area in which your child or young person lives. There is currently a national shortage of care workers across all health and care services which may impact on the availability and choice of care offered to your child or young person.

The care that NHS Dorset offers will always need to  be determined as clinically safe. Due to the restricted availability of care, the options offered to your child or young person will be the safest option that NHS Dorset are able to offer at that time. The person with parental responsibility or a child or young person with capacity has the right to decline care. Alternative arrangements would then need to be made by the person with parental responsibility.

Personal health budgets

From April 2014 anyone eligible for NHS continuing healthcare wanting to have their care provided outside of a care home setting may be able to receive the money they need to meet their healthcare needs as a personal health budget in the form of a direct payment. This gives people a greater choice over how, when and who provides their care and support.

Further information on what personal health budgets (PHBS) are – NHS England.

NHS Dorset also has an operational policy that explains in detail how personal health budgets are arranged within Dorset.

Healthcare reviews

If your child or young person is eligible their needs and support package will normally be reviewed within three months and thereafter at least annually. This review will consider whether the existing care and support package meets their assessed needs. If their needs have changed, the review will also consider whether they are still eligible for continuing care.

If your child or young person’s needs change in the future, you may cease to be entitled to continuing care. If this happens and care and support is still required, NHS Dorset will refer your child or young person to the local authority for an assessment.

Fast-track funding

Children or young people who require a fast-track assessment because of the nature of their health needs (such as palliative care) should be referred to NHS Dorset by their health professional as quickly as possible. This is so that NHS Dorset can assess the child or young person and put in place immediate support if there is an identified continuing care need.