Continuing Healthcare: Settings of Care Policy Consultation (2017)

On Tuesday 11 July 2017, the Governing Body of East Leicestershire and Rutland Clinical Commissioning Group (ELR CCG) approved an updated Settings of Care Policy, which aims to make Continuing Healthcare (CHC) funding fairer and sustainable for eligible patients.

About the policy

The policy determines how and when the CCG will support individual choice of care setting (e.g. care at home, in a care home or elsewhere) for people receiving CHC funding. It also guides the level of funding for providing care in that setting and includes criteria which ensures individual circumstances are taken into account.

Why the policy needed to change

The CCG needed to review the 2011 Settings of Care policy because it was out of date and did not include the option for patients to organise their own care using a Personal Health Budget

The CCG has a set budget that has to cover the healthcare needs of all local people.

On an annual basis, in Leicester, Leicestershire and Rutland we spend more on CHC funding than the majority of other areas across England – in 2015/16 we spent over £73.5million.

As commissioners we have to make decisions fairly and ensure that all those eligible for Continuing Healthcare have equal access to healthcare funding.

In doing so we want to ensure that patients have choice on where their care is delivered where it’s safe to do so. We needed to bring ourselves in line with other areas in the country.

What it means

For eligible people with complex needs, the full cost of their care is met by the CCG. Once the cost has been worked out, the new policy will allow the CCG to pay up to 10% more in order to facilitate their choice of where the care is provided.

Who we spoke to

ELR CCG began discussing this issue with CHC patients and the public in summer 2016. We wrote to 1300 patients in receipt of CHC asking them to complete a questionnaire to help us capture their views. We encouraged family members, carers and members of groups who support people in receipt of NHS Continuing Healthcare funding to share their views. We held an engagement event in July 2016 to provide more information to people who wanted to complete the survey. You can view the slides from this event here.

You can view the full findings of the questionnaire here.

This feedback was subsequently used to shape a formal consultation, which took place from 6 January 2017 to 20 February 2017.

We wrote to the 1300 patients in receipt of CHC to inform them of the consultation and invite them to a consultation event. The consultation was also widely publicised on our website, through stakeholders and the media. You can find this document in Easy Read format here.

We also held a consultation event for those affected on 19 January 2017. You can view the slides from this event here.

Listening to feedback

We carefully considered all of the feedback we received and made changes to the policy to reflect the points made by the public, including:

  • Where people are already in receipt of CHC they will continue to receive their care in the same setting whilst it remains clinically safe.
  • We have ensured we can consider the person’s personal and family circumstances individually at any stage of their life.

You can view the consultation analysis report here.

Approving the policy

On Tuesday 11 July 2017 ELR CCG’s Governing Body approved an updated policy which clarifies the circumstances by which we will fund over the cost of the package of care to keep people in their preferred place. Read more here.

Implementation of the policy

The policy will apply to all new cases deemed eligible for CHC funding. Existing CHC patients will be subject to the policy only if their clinical needs change.

Patients who receive packages of care funded by the Local Authority will not be affected by the Settings of Care policy review.

You can view the policy below.


Further Information:

The policy and full details of the engagement and consultation can be found in our July Governing Body papers here.


Area of Interest:

Long Term Conditions