July 2019: Paragraph 6 was added, regarding submission of the Checklist.

The Decision Support Tool is used to inform the decision as to whether a person is eligible for NHS Continuing Healthcare. It is not an assessment. It is a tool designed to collate and present information of the person’s needs including evidence from assessments and reports completed by members of the MDT and those who are involved in the delivery of care and support for the individual.

When a request is made by the Case Coordinator, an Adult Care practitioner, so far as is reasonably practicable, must attend a MDT meeting to complete a DST. To enable this to happen in a timely manner, practitioners should ensure they have provided three availability slots when completing and submitting a positive Checklist.

There will be cases where practitioners are requested to be part of an MDT for a person they are not currently involved with. In such cases they still have a responsibility to attend. This includes those who are self-funding their care.

The practitioner should record the following information in the person’s Adult Care records:

  • date the request to attend an MDT / DST meeting was received;
  • date of the meeting;
  • date they responded to the request;
  • whether or not they are able to attend;
  • reason for non-attendance, where applicable.

The practitioner should complete an assessment / review of the person prior to attending the MDT meeting. This will enable effective participation in the meeting and assist in ensuring that all of the person’s needs are appropriately considered in the decision making process for eligibility for NHS Continuing Healthcare. The practitioner should provide the Case Coordinator with a copy of the Adult Care Assessment as evidence to support the DST. This can be the most recent assessment, providing it is reflective of the person’s current needs. If the practitioner is unable to do this at the MDT meeting, they should provide a copy to the Case Coordinator within five working days.

In cases where the practitioner has completed and submitted the Checklist, it is expected that they will have also submitted a copy of the person’s adult care assessment. Where they have fully completed or added to the assessment prior to the MDT meeting, the practitioner should provide an updated copy to the Case Coordinator.

The practitioner must participate in making the MDT recommendation on the person’s eligibility.

The practitioner should record the MDT recommendation and, when known, the CCG’s decision in the person’s Mosaic record, either in the case notes and on a completed CHC Monitoring form.

When the decision on the person’s eligibility has been made the CCG will send a copy of the DST to the practitioner via secure email. The practitioner will upload this to the person’s case file on the Mosaic Care recording system.

In cases where the practitioner disagrees with the recommendation made by other members of the MDT (referred to as a split recommendation), the practitioner should state their own recommendation. This must be supported by a written, justified rationale which addresses the four key characteristics and applies the primary health need test.

Providing a detailed written rationale at the MDT meeting can be difficult. The practitioner can provide a brief verbal statement at the meeting and agree with the case coordinator that they will provide a detailed written rationale in one working day.