Level 5 -
Planning and commissioning care for people with complex health and social care needs.
Reference: OCC0786
Status:
SOC 2020 sub unit groups:
NHS, Islington Clinical Commissioning Group (CCG), Surrey CCG, Midlands & Lancashire CCG, Wirral CCG, Northumberland CCG, Ealing CCG, Doncaster CCG, St Helens CCG, Barnet CCG, Skills for Health
This occupation is found in a wide variety of organisations that oversee health and social care services such as Clinical commissioning groups, social services and community healthcare services. Continuing healthcare services provide care for over 60,000 people over the age of 18 annually across England. It is estimated that 70% are in nursing homes, and 30% have care in their own homes.
The broad purpose of the occupation is to work as part of a continuing healthcare team which provide packages of on-going care that are arranged and funded solely by the NHS. The associate continuing healthcare practitioner plays a key role in the assessment of individual’s complex health and social care needs that have arisen as a result of disability, accident or illness, and the planning and commissioning of the services for these individuals. They also act as the first point of contact for individuals and their carers offering support, care and advice about the service and for young adults and their family who are transitioning from children’s continuing care into this adult continuing healthcare service. The associate continuing healthcare practitioner may be required to work shifts including evenings and weekends.
In their daily work, an employee in this occupation interacts with the individuals and their family, friends and carers, that have been referred into the continuing healthcare service, are being assessed or are receiving packages of care. They work with nurses, social workers, doctors and other health and social care colleagues involved in planning, reviewing and delivering services provided to the individual guiding them with expert knowledge of the specialist continuing healthcare regulations. They also regularly work with finance and procurement colleagues and the service providers to ensure contracts are being delivered as agreed. They may also have contact with legal and claims companies who are representing individuals who do not agree with the outcome of the assessment process. The associate continuing healthcare practitioner will need to have good communication skills to advocate for individuals and guide them through the emotionally stressful assessment process and any dispute process. They will also be required to have a detailed knowledge of the health and social care services available for these individuals who have complex and varying needs. The associate continuing healthcare practitioner will be primarily office-based but will also visit the individual in their home, and in health and social care settings.
An employee in this occupation will be responsible for screening and assessing individuals for eligibility to continuing healthcare packages in line with the national framework for continuing healthcare, related legislation and policy. To support this assessment work, they undertake analysis, interpretation and evaluation of evidence from multiple health and social care professionals caring for the individual. The associate continuing healthcare practitioner will also be responsible for managing a caseload of individuals who have been found eligible. This involves the planning and reviewing of the complex health and social care packages ensuring they continue to meet their needs. They will work autonomously, exercising judgement and work in partnership with other health and social care professionals to undertake non-routine assessments and reviews on individuals in line with the law. In most instances their work will be overseen by a registered health or social care professional such as a nurse, social worker or occupational therapist. The associate continuing healthcare practitioner will also have line management or supervisory responsibility for junior members of the team, acting as a role model, planning and managing their work.
NHS, Islington Clinical Commissioning Group (CCG), Surrey CCG, Midlands & Lancashire CCG, Wirral CCG, Northumberland CCG, Ealing CCG, Doncaster CCG, St Helens CCG, Barnet CCG, Skills for Health
Undertake management and review of individual’s care packages, ensuring it continues to meet their agreed health and social care needs.
Contribute to planning an individual’s care plan ensuring it meets their agreed health and social care needs.
Contribute to continuing healthcare assessment of individuals health and social care needs using the mandated tools as outlined in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care.
Supervise staff assigned according to organisational policies and procedures.
Manage the continuing healthcare referral process ensuring referrals into the service are in line with the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care.
Collate and analyse evidence and assessment documentation from health and social care teams involved in caring for the needs of the individuals to enable a lawful eligibility decision to be made.
Co-ordinate and guide the multidisciplinary, multiagency team undertaking assessments using specialist policy knowledge to advise on appropriate process to deliver a policy-compliant recommendation regarding continuing healthcare eligibility.
Contribute to resolution of disputed eligibility funding decisions fairly, consistently and lawfully.
Contribute to commissioning services required to meet individual's health and social care needs as prescribed by the multidisciplinary team in partnership with the individual.
Monitor continuing healthcare provider service and personal health budget (PHB) contracts in accordance with procurement law, national policy and local agreements.
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In this map, the focused occupation is highlighted in yellow. The arrows indicate where transferable knowledge and skills exist between two occupations. This map shows some of the strongest progression links between the focused occupation and other occupations.
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