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SIA Statement: National Framework for Continuing Healthcare

Whilst SIA acknowledges that changed wording in the newly updated National Framework for NHS Continuing Healthcare (CHC) may lead to some better outcomes for patients, unfortunately it and the associated assessment tools fall far short of delivering evidence-based and equitable CHC eligibility assessments for some of the most vulnerable people in society.

SIA welcome changes such as those which ensure that advice will be sought from experts in an individual’s condition and are fully supportive of updates which will finally bring CHC assessments in line with the Care Act 2014.  We also appreciate the greater clarity given to the commissioning responsibilities of Clinical Commissioning Group’s (CCG’s), that will hopefully end the growing number of local CCG policies that force our members to choose between incarceration in care homes or inadequate and unsafe levels of care in their own homes.

However, SIA overwhelmingly sees this as a missed opportunity to create a piece of statutory guidance that could have revolutionised the delivery of this critical element of NHS provision for the most vulnerable members of our society.  The revised National Framework also fails to address the recommendations of the Public Accounts Committee, following their recent investigation into the CHC process.

SIA are particularly disappointed that the Department of Health and Social Care did not update and improve the NHS CHC assessment tools, which the Public Accounts Committee correctly identified as a key source of the poor quality and variation of NHS CHC eligibility decisions across the country.


Dr Rupert Earl, Chair of SIA said:

“It is very disappointing that the revision of the National Framework for NHS Continuing Healthcare falls short of the substantial changes needed to the associated assessment tools that we and other disabled people’s organisations have been calling for repeatedly from the Department of Health and Social Care.”

“This is unacceptable and the result is a missed opportunity.  It is unlikely to lead to the transformation that people paralysed by spinal cord injury need in order to be fairly assessed for their NHS Continuing Healthcare.  Instead, we remain at the mercy of a system which is at best a lottery and at worst a barrier to the vital care that spinal cord injured people need to live healthy and fulfilling lives in the community.”

The revised National Framework for NHS CHC will be implemented from October 2018.  More details and a link to the document are available on the NHS England website.

For further information about NHS CHC please visit our Resources Section.