Case Studies

The Clinical Commissioning Group CCG provides CHC Services to six CCGs

We initially undertook a Time and Motion Study looking at roles and activities within the department to assist the management team in restructuring the team and transforming the service.

We then undertook a Fast Track Review Project following a business case to deliver high quality, safe care, more cost effectively.

CHC Direct subsequently provided assessment services for:

• 3 month Continuing Healthcare Funding Reviews
• 12 month Continuing Healthcare Funding Reviews
• Funded Nursing Care Reviews by Checklist and by Decision Support Tool by Multi-disciplinary Team.
• Full Continuing Healthcare Reviews with a Multi-Disciplinary Team either Local Authority or constituted by CHC Direct.

This involved the development of a CHC Clinical and Administrative Pathway and Standard Operating Procedures and Work Instructions to deliver the end to end service from assessment booking; allocation of assignments; completion of the assessments and collection of evidence; full write up of documentation, audit and presentation of the case to the CCG.

A total of approximately 2,000 assessment were completed over a two year period the majority completed in twenty months.

We were also requested to undertake a Continuing Healthcare Process Mapping Project which involved writing an end to end process map with process flow diagrams for the Department. The purpose was for use as an operational process tool to inform new and existing staff of departmental practice. We also delivered training to the whole team for this

We supported a Continuing Healthcare Hospital Liaison Project providing the Consultant and reporting on findings.

The CCG also commissioned CHC Direct to undertake a Home based Care Review Project to enable them to better understand the market and the level and type of care provision available required for Individuals with Complex and Continuing Care needs.

CHC Direct continues to work with the CCG.

The Clinical Commissioning Group provides Continuing Healthcare Services on behalf of five CCGs.

We started working with the CCG in June 2015 and have since undertaken seventeen different cohorts of Continuing Healthcare Assessments. The CCG Commissioning Department has developed a business case for each cohort of work to improve quality of services delivered and ensure best value for the CCG.

The range of assessments include:

• Fast Track Reviews
• 3 month Continuing Healthcare Reviews
• 12 month Continuing Healthcare Reviews
• Clinical Commissioning and Placement Reviews for Individuals with Learning Disabilities and Mental Health needs including 1:1 Support Reviews
• Paediatric CHC Assessments and Reviews
• Full CHC Assessments by Decision Support Tool with Multidisciplinary Team
• Request for Review of Eligibility Decisions and Local Resolution Meetings

We have completed approximately 1, 500 assessments since July 2015

This involved the development of a CHC Clinical and Administrative Pathway and Standard Operating Procedures and Work Instructions to deliver the end to end service from assessment booking; allocation of assignments; completion of the assessments and collection of evidence; full write up of documentation, audit and presentation of the case to the CCG.

We have also undertaken two Projects for the CCG.

The FNC Review Project where we looked at the numbers of Individuals in receipt of Funded Nursing Care Contribution in two areas and assessed their ongoing needs. The information gleaned was analysed and reported on to the CCG.

The Fast Track Referrals Project required us to consider Fast Track Referrals from the local hospitals and analysis of the referral process; ongoing funding; service quality and outcomes for Individuals in receipt of Fast Track Funding.

CHC Direct continues to work with the CCG.

CHC Direct initially provided appropriately trained Assessors to augment the in house team managed within the organisational structure.

We also worked with the CCG to deliver Clinical Commissioning and Placement Reviews for Individuals with Learning Disabilities, Mental Health and Complex Needs. The aim was to assess the quality of the placement and ensure best value for the CCG.

CHC Direct provided a Project Delivery Team of health and social care professionals led by the CHC Direct Commissioning and Contract Management Team as well as appropriate administrative support with clear links to the CCG Project Lead. The team worked with the specified cohort of individuals defined by the Project Lead managing the workload from initial appointment to next commissioning review ensuring all records are up to date and the next review meeting planned.

The service was provided for a defined period of time based on the number of individuals within the cohort. The Project was fully managed with regular reporting to the Project Lead together with a final Project Report.

The Project activities include clinical assessment; contractual review and provider negotiations using established market management and independent sector commissioning and procurement strategies and a costed care plan methodology.

The Commissioning and Contract Management Team identified best value commissioning options.  Any recommendations regarding commissioning actions and developments were be fed back to the CCG Project Lead. Any further case management and moving on recommendations would be identified to the CCG for further action.