If your relative’s Checklist Assessment is successful, they will then progress to a Full Assessment. The Full Assessment should happen within 28 days of the Checklist Assessment taking place.
The Full Assessment is carried out by a Multi Disciplinary Team (MDT). This team must consist of at least two people, one Healthcare Professional and one Social Services Professional, but may well include more Healthcare Professionals depending on your relative’s condition. A co-ordinator will be appointed to lead the assessment process.
Your relative will be advised when the assessment is taking place and their advocate should be entitled to attend.
Prior to the Full Assessment the MDT are required to review all the relevant medical and care notes in relation to your relative’s needs.
The assessment follows a similar process to the Checklist Assessment and uses the same domains, plus one further domain for “Other” requirements.
Clients often say that these Full Assessment meetings are intimidating and that the MDT often uses tactics to position what’s being said to their own advantage.
The assessment, whilst similar to the Checklist Assessment, uses a different scoring system. Your relative’s needs are assessed as either N= No needs L = Low needs M = Moderate needs P = Priority needs or S = Severe needs
Your relative should qualify for Continuing Healthcare Funding if they score Severe in any of the * domains, or as Priority in two or more other domains. However, assessment is subjective and case by case circumstances will be taken into account. The NHS Guidelines state that if there is any uncertainty or disagreement within the MDT about what score to allocate, then the higher of the scores should be applied.
Once the Full Assessment has been completed, the report is sent to the CCG in your area, who make the final decision on whether your relative qualifies for NHS Continuing Healthcare Funding or not. It is not the MDT who makes the decision, although they will make a recommendation.
If your relative’s Full Assessment is successful they will qualify for Continuing Healthcare Funding and it is then the responsibility of the NHS to pay for 100% of their care.
The NHS will undertake another Full Assessment after three months and again annually. If circumstances change, their eligibility may be reconsidered. Your relative will be advised when any further Assessments are going to take place and they and their advocate will have to prepare for the process in exactly the same way.
If you disagree with the decision, the Appeals process must be explained to your relative when they are provided with a copy of the Full Assessment and if you disagree, you have the right to Appeal the Assessment.
It may be on reflection after the Full Assessment has taken place that you and your relative agree that their care needs are not primarily healthcare needs, which will be the case for some people. In that situation your relative will move from the care of the NHS into the care of the Local Authority/Social Services.
Nevertheless, once a Full Assessment has been undertaken, that will form the baseline for any future assessments. Knowing their score and the areas in which they have healthcare needs means that you have a start point to assess any deterioration of their healthcare needs over time, which can then form the basis of a request for re-assessment.