Determining children and young people’s eligibility to have care and accommodation funded by the NHS

  • If your child has a primary health need, then he or she may be entitled to have their care and accommodation funded entirely by the NHS.
  • NHS Continuing Healthcare is the term used to describe a package of care arranged and funded entirely by the NHS for children and young people who are not in hospital but have complex, on-going healthcare needs.
  • We offer support in this area and can assist you throughout the whole assessment process from start to finish.

Committed to helping children and young people obtain access to the care they deserve

To determine whether your child is eligible to receive care and accommodation funded by the NHS there are 10 distinct care domains or areas of need, which must be considered, each of which is sub-divided into different bands for scoring. The 10 distinct bands within each area of need are designed to reflect the nature, intensity, complexity and unpredictability of your child’s needs.

It is vital that the views of your child and family are taken into account throughout the assessment process to ensure the assessment is accurate. These assessments must be evidence-based, and your child and family must be invited to participate.

If you disagree with any decisions regarding your child’s eligibility, these can be challenged by writing to the relevant Clinical Commissioning Group requesting a review, in accordance with the local complaints procedure.

Success requires:

  • Detailed knowledge of the National Framework for Children and Young People which governs the assessment process.
  • Experience of the assessment process and an understanding of how applications should be presented at the assessment where a ‘Decision Support Tool’ is completed. This ensures you have the evidence required to demonstrate your child’s eligibility.
  • It is also crucial to ensure that the agreed Decision Support Tool completed at the assessment identifies all your child’s care needs in order to provide a good platform for the negotiation of a care package once eligibility has been agreed.
  • The ability to advocate your child’s and/or your family views clearly and confidently throughout the assessment process.

Continued support throughout the whole assessment process

We can offer you practical support by helping you throughout the assessment process. This includes:

  • Making an application for Continuing Healthcare for Children and Young People
  • Collating evidence ahead of your assessment or appeal
  • Preparing submissions explaining why your child is eligible
  • Challenging an eligibility decision
  • Advocacy at all stages of the assessment and appeals process
  • Negotiation of a care package once eligibility has been agreed
  • Advocacy at Annual Reviews

We understand that any issues regarding the wellbeing of your child and family will be extremely important to you. We approach continuing care issues with sensitivity, whilst also ensuring that we can generate the best possible outcome for you and your family as efficiently as possible.

The assessment process to determine eligibility for children and young people is governed by an entirely separate National Framework to the assessment process for adults. If you would like information on NHS Continuing Healthcare for Adults please view our NHS continuing care applications and appeals page.

For a free initial assessment download our questionnaire and return it to Mea North.

If your child has a disability as a result of medical negligence or personal injury our specialist teams may be able to assist you in investigating and taking forward a compensation claim. For a no obligation discussion contact Tim Spring (medical negligence) or Damian Horan (personal injury).

Factsheet

View our ‘Children act assessments’ factsheet.

Contact our solicitors

Get in touch with our legal experts for advice.