Children and young people’s continuing care within health services
A continuing care package will be required when a child or young person (up to the age of 18 years) has needs arising from very complex health needs. This could be due to multiple and enduring health care needs due to disability, accident or illness.
The Children and Young People's Continuing Care team follow the National Framework for Children and Young People's Continuing Care (2016). The Framework is NOT Statutory but provides guidance to determine if a child or young person's health needs require support, over what can be provided by the routinely or specialist commissioned… D.o.H. National Framework for Children and Young People's Continuing Care
Children and young people’s continuing care information leaflet
Transition Process Flowchart
What is Children’s Continuing Care?
A continuing care package will be required when a child or young person (up to the age of 18 years) has needs arising from very complex health needs. This could be due to multiple and enduring health care needs due to disability, accident or illness.
These needs are so complex that they cannot be met by existing universal, mainstream and specialist services alone or cannot be sustained by the family without a bespoke package of support.
When additional support is needed this is referred to as ‘Continuing care’
Continuing care is not needed by children or young people whose needs can be met appropriately through existing universal or specialist services through a case management and multi-agency approach.
Where a child or young person also has a special educational need or disability ( ), which is often the case, then CCG’s and local authorities should endeavour to coordinate the assessment and agreement of the package of continuing care as part of the process to develop the child’s Education, Health and Care plan.
Who is eligible?
Any child or young person up to their 18th birthday who has a complex health need may be eligible for continuing care. It is important to note that diagnosis of a particular disease or condition is not in itself a determinant of a need for continuing care; not everyone with a disability or long term condition will be eligible.
When a young person reaches 18, the adult NHS Continuing Healthcare arrangements apply. In Knowsley CCG we have a CHC team for any enquiries please contact the team: knccg.chcteam@nhs.net
How can we access Continuing Care for Children and Young People?
Referrals can be made by healthcare professionals such as consultants, GPs, specialist nurses, children’s community nurses, school nurses and other professionals such as social workers and SENCOs.
Professionals - please contact Specialist Children’s Nurse in Knowsley CCG via the Team inbox: knccg.chcteam@nhs.net
Parents/ carers- please discuss with your GP, community nurse, social worker, school or hospital professional.
The process and role of Complex Panel
Continuing care eligibility is determined by the presenting health needs, their level of complexity and whether existing services can meet the identified outcomes.
A signed consent from parents/carers is needed in order for us to request submission of recent and relevant health and care assessments. These are then collated to inform the National Continuing Care Framework screening tool which is used to assess eligibility for children’s continuing care.
Once indicated that a child/young person may be eligible for continuing care, a full health assessment will be completed by a community nurse or appropriate health professional and this will include discussion with the parent/carer and/or young person.
All assessments will include the preferences of child or young person and their family.
The assessment of needs and eligibility takes place in collaboration with other services such as education, social care and allied health professionals.
Complex Needs Panel
The Complex Needs Panel is held weekly. Panel members include children and family services senior leads from Health, Education and Social Care. The case request or the review of an existing package is presented to panel by the referrer and/or key health/social care/education representatives.
The joint agency decisions are agreed at Panel and if the child/ young person meet the eligibility criteria then the shared funded care package is confirmed and signed off by Health and Social Care senior leads.
Children and young people’s care packages are reviewed regularly (3-6 months) as the young person may at some point either no longer require continuing care or meet the eligibility criteria if their condition and needs change, or they may require additional support.
Cases can be presented outside of panel dates for fast track decisions where an emergency/end of life package is needed.
Eligibility for continuing care is assessed before the review of each package at Panel.
Continuing care packages are time limited, not indefinite, and as health needs change, so may the package.
The Specialist Children’s Nurse will quality assure the package of care through regular review to ensure the developing child or young person’s needs continue to be supported.
Transition to Adult Services
A child/ young person who meets the eligibility criteria for children’s continuing care will not necessarily meet the criteria for adult continuing health care. It is therefore recommended that joint reviews with the adult continuing health care nursing team are undertaken from age 16 onwards so that plans for transition to adult services are in place.