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Continuing Healthcare

John Petters made this Freedom of Information request to NHS Central Eastern Commissioning Support Unit

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Dear NHS Central Eastern Commissioning Support Unit,

Freedom of Information Request

The Decision Support Tool used to establish a primary health need when considering an individual for Continuing Health Care, funded by the NHS states at PG 31:
31. At the end of the DST, there is a summary sheet to provide an overview of the levels chosen and a summary of the person’s needs, along with the MDT’ (Multi Disciplinary Team) recommendation about eligibility or ineligibility. A clear recommendation of eligibility to NHS continuing healthcare would be expected in each of the following cases:
• A level of priority needs in any one of the four domains that carry this level.
• A total of two or more incidences of identified severe needs across all care domains.
Where there is:
• one domain recorded as severe, together with needs in a number of other domains, or
• a number of domains with high and/or moderate needs,
This may also, depending on the combination of needs, indicate a primary health need and therefore careful consideration needs to be given to the eligibility decision and clear reasons recorded if the decision is that the person does not have a primary health need.
In all cases, the overall need, the interactions between needs in different care domains, and the evidence from risk assessments should be taken into account in deciding whether a recommendation of eligibility for NHS continuing healthcare should be made. It is not possible to equate a number of incidences of one level with a number of incidences of another level, as in, for example ‘two moderates equals one high’. The judgement whether someone has a primary health need must be based on what the evidence indicates about the nature and/or complexity and/or intensity and/or unpredictability of the individual’s needs”.

Questions:
1 Please provide, the number of assessments for funding using DSTs and MDTs for Continuing Healthcare since January 2012 by the NHS Central Eastern Commissioning Support Unit and state the following,

2 How many were refused funding?

3 Of those refused, how many DSTs scored 1 severe and 1 or more high scores in the care domains?

4 Of those refused, how many DSTs recorded “clear reasons if the decision is that the person does not have a primary health need”.

5 How many MDTs comprised only 2 members?

6 How many ‘out of panel’ decisions were made?

Yours faithfully,

John Petters

FOI England (NHS ENGLAND), NHS Central Eastern Commissioning Support Unit

Dear Mr Petters,

 

Our reference: SDR-242791 - Acknowledgement

 

Thank you for your Freedom of Information (FOI) request dated 10 April
2014, and originally addressed to the Central Eastern CSU.

 

Please be assured that your request is being dealt with under the terms of
the Freedom of Information Act 2000 and will be answered within twenty
working days.

 

If you have any queries about this request or wish to contact us again,
please email [1][email address] and the message will be
forwarded appropriately. Please remember to quote the above reference
number in any future communications.

 

Please do not reply directly to this email. This message has been sent
from a central mailbox and incoming messages will not be received.

 

Yours sincerely,

 

Michelle Butterworth

Case Officer (Freedom of Information)

Customer Contact Centre

Transformation and Corporate Operations Directorate

 

NHS England

PO Box 16738 | Redditch | B97 9PT

0300 3 11 22 33

[2][email address]

[3]www.england.nhs.uk

 

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References

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1. mailto:[email address]
2. mailto:[email address]
3. http://www.england.nhs.uk/

Sansom Alison (0CG) NHS Central Eastern CSU,

I presume that we will only provide info from April 2013 when CESCU came into being. I will probably need to do this over the weekend once I have got the benchmarking report out of the way.

Alison Sansom
Assistant Director, Continuing Healthcare

Charter House, Parkway, Welwyn Garden City AL8 6JL

DD 01707 369522
[mobile number]

Working days: Mondays-Fridays

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FOI England (NHS ENGLAND), NHS Central Eastern Commissioning Support Unit

Dear Mr Petters,

 

Re:      Freedom of Information request (Our Ref: SDR-242791)

 

Thank you for your Freedom of Information (FOI) request dated 10 April
2014.

 

Your exact request was:-

 

“1 Please provide, the number of assessments for funding using DSTs and
MDTs for Continuing Healthcare since January 2012 by the NHS Central
Eastern Commissioning Support         Unit and state the following,

2 How many were refused funding?

3 Of those refused, how many DSTs scored 1 severe and 1 or higher score in
the care domains?

4 Of those refused, how many DSTs recorded “clear reasons if the decision
is that the person does not have a primary health need”.

5 How many MDTs comprised only 2 members?

6 How many ‘out of panel’ decisions were made?”

 

NHS England holds some information relevant to your request.

 

In response to Question 1, since 1 April 2013, the Hertfordshire,
Bedfordshire & Luton Business Unit of NHS Central Eastern Commissioning
Support Unit (CSU) have dealt with 884 assessments (information previous
to the creation of NHS Central Eastern CSU on 1 April 2013 is unavailable)

 

From 1 January 2012 until 31 December 2013, the Essex Business Unit of NHS
Central Eastern CSU have dealt with 1,626 assessments (information after
31 December 2013 is not yet available)

 

In response to Question 2, since 1 April 2013,  the Hertfordshire,
Bedfordshire & Luton Business Unit of NHS Central Eastern CSU have found
392 claims to be not eligible (information previous to the creation of NHS
Central Eastern CSU on 1 April 2013 is unavailable)

Since 1st January 2012, the Essex Business Unit of NHS Central Eastern CSU
have found 1,025 claims to be not eligible (information after 31 December
2013 is not yet available)

 

In response to Questions 3 to 6, NHS England may hold information relevant
to your request.  In assessing the information you have requested as it is
currently framed, would exceed the cost limit as set out in Section 12(1)
of the FOI Act. Section 12(1) states that a public authority can refuse a
request if complying with it would exceed the appropriate limit of £450
(which represents 18 hours).  This represents the estimated cost of one
person spending this time in determining whether the information is held,
and locating, retrieving and extracting the information. I have outlined
reasoning for invoking Section 12(1) below.

 

To locate and retrieve the information you have requested would require
NHS England to access a number of computer files over a period in excess
of 12 months. We can estimate there are around 2510 which would require
locating and reviewing in order to extract relevant information in
relation to your request. We have estimated under section 12(1) of the FOI
Act that to locate, retrieve, extract and collate the information
requested may take up to 20 minutes to conduct and therefore, potentially
take up to and over 836 hours to complete. As a result, this takes over
the time and cost threshold in considering an FOI request and any
appropriate action to be taken.

 

Section 12(1) is an absolute exemption therefore we are not required to
assess the public interest test in its application.

 

However, if you were to refine your request for information within more
specific margins, for example over a smaller time period, then we may be
able to continue processing your request. Please note we cannot guarantee
that Section 12(1) or any other exemptions will not apply to any
information requested.

 

I hope this information is helpful. However, if you are dissatisfied, you
have the right to ask for an internal review by writing to us, within two
months of the date of this letter, to:

 

NHS England

PO Box 16738

REDDITCH

B97 9PT

 

Email: [1][email address]

 

Please quote the reference number SDR 242791 in any future communications.

 

If you are not content with the outcome of the internal review, you have
the right to apply directly to the Information Commissioner for a
decision. The Information Commissioner’s Office (ICO) can be contacted at:

 

The Information Commissioner’s Office

Wycliffe House

Water Lane

Wilmslow

Cheshire

K9 5AF

 

Telephone: 0303 123 1113

Email: [2][email address].uk  

Website: [3]www.ico.gov.uk

 

Please note there is no charge for making an appeal.

 

Please be aware that in line with the Information Commissioner’s directive
on the disclosure of information under the FOI Act, your request will be
anonymised and published on our website as part of our disclosure log.

 

Please do not reply directly to this email. This message has been sent
from a central mailbox and incoming messages will not be received.

   

Yours sincerely,

 

 

Michelle Butterworth

Freedom of Information

Customer Contact Centre

Transformation and Corporate Operations Directorate

 

NHS England

PO Box 16738 | Redditch | B97 9PT

0300 3 11 22 33

[4][email address]

[5]www.england.nhs.uk

 

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References

Visible links
1. mailto:[email address]
2. mailto:[email address]
3. http://www.ico.gov.uk/
4. mailto:[email address]
5. http://www.england.nhs.uk/

We don't know whether the most recent response to this request contains information or not – if you are John Petters please sign in and let everyone know.