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Clearing a 5,000-patient backlog of continuing healthcare assessments

We worked in partnership with local authorities to successfully complete retrospective assessments of individuals supported via COVID-19 funding arrangements during the suspension of the NHS Continuing Healthcare Framework.

The NHS Continuing Healthcare Framework was suspended from March to August 2020 due to COVID-19. All care that facilitated hospital discharge or prevented admission to hospital during that period was automatically paid for directly by the NHS without assessment. Once the framework was reinstated, there were over 5,000 patients due a ‘deferred assessment’ which needed completing as soon as possible. Clinical commissioning groups (CCGs) would receive funding in November 2020 to support individuals eligible for NHS CHC funding.

To establish an efficient process, health and social care systems employed a ‘Trusted Assessor’ model, designed to reduce delays when people are ready for discharge. It is based on providers adopting assessments carried out by suitably qualified ‘Trusted Assessors’ working under a formal, written agreement.

The Midlands and Lancashire Commissioning Support Unit (MLCSU) set up projects supporting the CHC activity based on the Trusted Assessment model in five integrated care systems (ICSs). Together with CHC expertise, we also employed clinical and business resource to address the issue.

Working in collaboration with CCGs, NHS trusts, local authorities, community providers and others was key to completing the retrospective assessments This was achieved through excellent partnerships, the development of key systems and exceptional working practices to ensure deadlines were met.


All care packages across the five ICSs, which were funded automatically by the NHS during the first phase of the pandemic, have now been assessed against the core NHS CHC Framework. This ensures that the packages:

  • Provide the most appropriate care according to individuals’ needs
  • Are realigned to the correct funding stream.

Eligible patients are now funded by core CCG CHC budgets. For remaining patients, the payment of their care costs has transferred from the COVID-19 budget to local authority responsibility, which has determined a variety of different pathways to support their care costs.

The successful completion of assessments also earned the team a nomination for ‘Best working across CCGs and local authorities’ at a national awards ceremony by the CHC Strategic Improvement Programme (SIP) Collaborative.

“I would like to nominate for recognition the MLCSU Staffordshire and Stoke division for the ‘Best working across CCGs and local authorities’ category, in my capacity as a senior social worker working for Stoke-on-Trent City Council. 

“I do want to highlight the effectiveness of employing a multi-agency partnership approach that has ensured retrospective assessments of individuals supported via COVID-19 funding arrangements, during the suspension of the NHS CHC National Framework successfully within time scales.”

National award nomination submitted by Stoke-on-Trent City Council