Oldham PCT Continuing Health Care Pathway

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Oldham PCT Continuing Health Care Pathway
Anita Roughley Associate Director Joint
Commissioning
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• Continuing NHS Healthcare TeamJoint
  Commissioning (1)
• Lead Clinician (Associate Director,
  Responsibility for Continuing Health Care joint
  commissioning, appropriate resource allocation,
  procurement, market management, quality control
  and forecasting)
• Complex Case Manager (Case and care management of
  clients where needs are complex costly and
  changeable )
• Continuing Care Officer (CHC process management,
  ensuring clarity and quality control of CHC
  function at all points of the process )

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• Continuing NHS Healthcare Team
• Joint Commissioning (2)
• Administrator (Database management, Invoice
  management)
• Secretary

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CHC Process Patient in Hospital (1)Patient
identified as having complex needs by ward staff
or Transfer Of Care Team Assessments completed
by all required professionalsWard MDT meeting,
Assessments are discussed, and the discussion
minuted. This discussion includes the patient and
their carer. Transfer of Care team or hospital
social work team act as care coordinatorCHC
Eligibility criteria applied as part of MDT
discussion with rationale for decision making
recordedSubmission of CHC application forwarded
to the Commissioning Continuing Health Care
Team
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CHC Process (2)Application received by
Commissioning CHC TeamApplication checked on
receipt for appropriate information (Minimum data
set includes all relevant professional
assessments, Proposed Care Plan, Risk Assessment,
CSCI Report of provider if identified, MDT
minutes and MDT eligibility criteria)
Application logged onto CHC databaseAny
missing information requested from Care
Coordinator prior to accepting for panelIf
information is complete, the case is Booked
into CHC Panel which meets weekly and appointment
issued to care coordinator. (Fast track process
for urgent cases is also in operation)
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CHC Process (3)CHC Panel Consists of
Oldham PCT Associate Director, Joint
Commissioning (Registered General Nurse)
Oldham MBC Adults and Community, Head of
commissioning (Social Worker) Pennine Care
MH Trust Governance Manager (Registered Mental
Nurse) Oldham PCT Learning Disability
Representative (Allied Health Professional)Case
is presented at CHC panel by care
co-coordinatorCHC Panel consider the case
presented by the care coordinator and apply the
eligibility criteriaDecision made, date for
review set, and any recommendations
recordedLetter to care coordinator to confirm
outcome, review and further actionsLetter to
patient and family to advise outcome of panel
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CHC Process (4)CommissioningLetter forwarded to
provider with contractRequests made in the
letter for specific information from the provider
which is appropriate to the care provision for
the individual caseFinancial Forecast logged
onto CHC databaseCommissioned Care package case
monitored by Complex Case Care Manager (CCCM) in
association with patients care coordinator
Care provided reviewed at appropriate intervals
for patients case(minimum is once in 12
months)Any changes to provision identified by
CCCM and is brought back to CHC panel for
decision making by individual care
co-coordinator
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Actions Baseline Audit to forensically
understand the whole of the CHC Caseload
Training of staff at all levels in all
organisations to reinforce the need for a quality
process and to raise awareness that CHC is part
and parcel to everyday, not extra or
separateDatabase reinforced to further
develop and maintain the understanding of the
caseload, accurately forecast commitment and
identify priorities for commissioning
Consistency of Decision Making by Panel using
regular membership Improved record keeping
within case files to enable audit trail Using
data collection from data base to inform
Commissioning processesEstablishment of
internal CHC Review Group and CHC financial
planRegular Board reporting of identified
risks
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Future Strategic developments(1)Increase in
Joint Commissioning with Local Authority
colleaguesImproving Contracting and procurement
with ProvidersMarket Management by
CommissionerCentral Resource FilePreferred
Provider DevelopmentReduction in numbers of
spot purchases and increase in contracted
services Greater Manchester (NW) wide
Commissioning of CHC placements to achieve cost
efficiencies
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Future Strategic Developments(2)Performance
Monitoring of the CHC process across Greater
Manchester Use of tender process to encourage
provider competitivenessCommissioner driven and
developed marketJoint Commissioning Unit as
part of Commissioning a Patient Led NHSpolicy
developmentPreparation for the CHC National
Framework Introduction
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Policy Context Greater Manchester Continuing
Health Care Eligibility CriteriaGreater
Manchester Continuing Health Care Eligibility
Criteria AddendumCommissioning a Patient Led
NHSFitness For PurposeStandards for Better
HealthNHS Commissioning FrameworkNational
Framework for Continuing Health CareOur Health
Our Care Our SayNational Service
FrameworksSingle Assessment ProcessCare
Programme ApproachFreedom Of InformationPatient
Advice and Liaison Patient and Public
Involvement
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Further Information AvailableWhat the database
recordsWeekly Panel paperworkProvider
ContractTraining PackGM CHC leads
commissioning sub group workFinancial Plan
Framework
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Contact DetailsAnita Roughley Associate
Director Joint CommissioningOldham PCTEllen
House Waddington StreetOldhamOL9 6EETel. 0161
622 6525Emailanitar_at_nhs.net