A Continuing Care package will be required when a child or young person has needs arising from disability, accident or illness that cannot be met by existing universal or specialist services aloneThis is the definition of what a Continuing Care package is. This is where the NHS will fully fund all services required by a child to meet their health needs.How to ApplyThere is a two stage process where a referral is firstly made to the Clinical Commissioning Group (CCG) and they will then carry out an assessment. The second stage is the decision making process where the package of care is then developed.Assessments are split into two stages where there is firstly a checklist which is completed by a nurse. This will inform whether a full assessment is required. CCGs are advised that they should make such decisions quickly in a transparent manner so that the family are fully aware. This pre-assessment should not take more than two days.A decision support tool will then be completed by a multi-disciplinary team comprising of the child if they are old enough to be involved, their parents, medical professionals, their nurse and if possible a social worker. They will record the child’s needs in the following domains:-Challenging behaviourCommunicationMobilityNutritionContinenceSkin tissue viabilityBreathingDrug therapy and medicationPsychological and emotional needsSeizuresHow Is the Decision Made?The nurse who will be in charge of completing the decision support tool will then make a recommendation to the local Clinical Commissioning Group. There will be a multi agency meeting of senior health and social care professionals and they will then make a decision. If the child is eligible then their family will be informed in writing and contacted to discuss the next stage of the process.The decision should be made within six weeks of the referral.Is There An Appeal Process?There are three options for appeal, firstly one can complain about the process in which an assessment took place however this is unlikely to change a decision. The formal appeal process is for there to be a local resolutions meeting followed by an independent review panel if necessary.Meeting Care NeedsA Care Plan will then be drawn up for the child. It is expected that the Local Authority will have to work with the CCG as they will be responsible for any social work functions. The legal position is that Children Services cannot fund any Social Care services which are related to the child’s medical needs.There is an interface with Education Health and Care Plans as there are common elements in both processes so they should be brought together to create a single set of needs and outcomes. The CCG and Local Authority should work together to make the Plans work and have joint arrangements to see how Continuing Care fits with the process. The same information and professionals may be involved so there should be an agreed process and sharing of resources rather than duplication. The wishes and the child and family should always be at the core of this process.To find out more about how Boyes Turner's specialist Community Care team can help you please contact us or call 0800 124 4845.