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child funding

A brief guide to “Transition” - child to adult care funding

What Is Transition?

The term “transition” is used to describe the period when a child moves from the “care” of the Local Authority to adult services i.e health care provided by the NHS under the term “NHS Continuing Healthcare Funding” or “CHC Funding” for short.

Currently all of your child’s needs are met by the Local Authority who have a duty under the Care Act and Section 17 of the Children’s Act 1989, thus, in the most part, all services/equipment may be provided to you free of charge and you, as a parent/guardian, are not subject to any financial assessment to determine eligibility of these services (means testing).

This changes when your child becomes an adult (reaches 18).

During the “transition period” assessments are undertaken to determine whether or not your child’s on-going needs will be classed as being a “health” or “social” need. If your child is assessed as having a “health” need, then CHC Funding should be granted which means the NHS will take over the responsibility of your child’s care upon your child reaching the age of 18. If it is determined that your child has “social” needs then any services or care needs that your child has will be subject to a Local Authority Financial Assessment (a means test). If, following the financial assessment it is determined that the child is not eligible for funding, then it is likely that the current services/equipment will be withdrawn. If your child is eligible for Local Authority Funding, they will take over the responsibility of your child’s care. However, the Local Authority may not have the funds to provide everything your child needs, in which case who will fund the gap? In the majority of cases, any shortfall in services is either filled by family/friends providing help, or by the family paying for services (such as care) privately.

This can amount to thousands of pounds, and what happens when the money runs out?

It is extremely important to ensure that “transition” is given early consideration to enable you and your family to plan for your child’s future needs.

At what age should Transition Planning begin?

Ideally consideration with regard to transition should commence when a child reaches the age of 14, but in our experience this is not adhered to. Upon the age of 16 a Social Worker should notify the Clinical Commissioning Group (CCG) that the child will need to be screened for possible NHS CHC funding, and at the age of 17 the formal process of eligibility for NHS CHC funding should begin by way of a Multi-Disciplinary Team (MDT) arranging a meeting in order to complete a document called a “Decision Support Tool” (DST).

Who should be involved in the DST Meeting?

It is important that the Multi-Disciplinary Team consists of professional from both health and social care, and we would also recommend the child’s Social Worker also forms part of the Team given their prior involvement of your child’s case, in some instances over a lengthy period of time. It is important to bear in mind that the professionals who make up the MDT may not have in-depth knowledge of your child or his/her needs, thus it is essential to try and obtain evidence from other professional sources such as, perhaps, your GP, a Consultant or schooling professionals.

We cannot stress enough how vital this period of transition is for both your child and for you as a family. It is imperative that as much evidence as possible is obtained in readiness for the DST Meeting and you need to be prepared for the possibility that once your child becomes an adult, he/she may no longer be eligible for the same care package that had been in place since they were a child. Furthermore, there may be a change of benefits and/or tax credits to which you have been entitled.

Preparation is key to the transition process; the last thing you want when your child turns 18 is for there to be a gap in the care services that they require.

How can Care Necessities help?

The team at Care Necessities specialise in providing care fee funding advice to individuals who may have concerns as to eligibility for NHS and Local Authority funding. We are able to consider an individual’s funding entitlement, and additionally identify whether there has been any breach of process by the NHS at any assessment. We also attend assessment hearings as Advocates on behalf of clients and prepare funding appeals.

In addition to offering guidance and support on the healthcare funding process, we can also prepare bespoke care records/charts, designed specifically to work in conjunction with the NHS Continuing Healthcare Checklist and Decision Support Tool assessment documents to ensure an individual’s care records accurately record care needs and, consequently, positively assist with the assessment of need.

We also have expertise in respect of benefit entitlement, whether this falls into the realms of NHS Continuing Healthcare, public funding or obligations upon Deputies under the Office of Public Guardian standards.

We are available to provide our clients and trusted partners with guidance and support on these challenging issues, and would be happy to discuss any concerns you may have.