Continuing Healthcare: Settings of Care Policy consultation

Members of the public and local patients receiving Continuing Healthcare (CHC) funding are being invited to take part in a public consultation on changes to a policy which aims to make CHC funding fairer and sustainable for all eligible patients across Leicester, Leicestershire and Rutland (LLR).

The local Clinical Commissioning Groups (CCGs) responsible for LLR – East Leicestershire and Rutland CCG, Leicester City CCG and West Leicestershire CCG are proposing changes to the current ‘Settings of Care’ policy.

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

Background on the ‘Settings of Care’ policy

The existing policy has been in place since 2011. It pre-dates recent developments such as Personal Health Budgets (PHBs) which provide an amount of money to individuals with identified health and wellbeing needs to support care which is planned and agreed between individuals, families and their local NHS team.

Your local CCGs want to ensure the refreshed policy takes into account the introduction of PHBs and that it enables:

  • robust, fair consistent and transparent commissioning decisions by the CCGs
  • consistency in the services that individuals are offered
  • value for money in the purchasing of services for individuals
  • effective partnership working between healthcare providers, NHS bodies and the Local Authorities in the area
  • individual choice as far as is reasonably possible.

There are currently over 1,300 people in Leicester, Leicestershire and Rutland who receive NHS Continuing Healthcare funding. On an annual basis in LLR we spend more on CHC funding than the majority of other areas across England – in 2015/16 we spent over £73.5million.

At a time when pressures on the NHS have never been greater with an ageing population and a significant increase in the number of people who need CHC funding, the CCGs have a duty to ensure that services are clinically and financially sustainable and that everyone who is eligible has access to appropriate care.

You can view the full draft policy document here.

Pre-consultation engagement

In summer 2016 we wrote to all patients currently in receipt of NHS Continuing Healthcare funding asking them to complete a questionnaire to help us capture their views. We also encouraged family members, carers and members of groups who support people in receipt of NHS Continuing Healthcare funding to share their views.

You can view the full findings of the questionnaire here.

Based on feedback from that questionnaire, we are proposing:

  • A reduction to the current 25% spending limit – the current policy allows the CCGs to spend up to 25% more than the most cost effective option to provide care in a setting of a patient’s choice. We are proposing two options for you to consider.
  • The introduction of clearer exceptionality criteria – such as someone at the very end of their life.
    The implementation of guidelines to reduce clinical risk – 24-hour care from a registered nurse would only be provided in a nursing home and hospital level care would only be provided in a specialist unit.
  • Use of registered care settings – we will try to offer and place patients with preferred care providers. If their choice is not available, to meet reasonable assessed care needs, we may place people with an alternative care provider who meets the requirements.

How the changes could affect you
Once the policy has been refreshed and approved, any changes would be applied at the patients’ next annual review or, in the case of new patients, at the point people are determined eligible for Continuing Healthcare funding.

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

Formal consultation 

A formal consultation on the proposed changes was launched on 6 January 2017. Affected patients have been written to with details of how to complete the consultation. You can find this document in Easy Read format here.

The survey can be completed online at, by telephone: 0116 295 3405 by email at

We held a consultation event at Leicester Racecourse on Thursday 19 January.

The consultation closes on Monday 20 February 2016.

You can also contact us if you would like this information in another language or if you have another specific request.

Find out more here.



Further Information:

Please find attached the Settings of Care draft Policy here:


The consultation document is available in Easy Read format below:


Area of Interest:

Long Term Conditions