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What is Hospital based Complex Clinical Care?

Hospital Based Complex Clinical Care is care that can only be provided for in hospital or a Specialist NHS Unit. If you cannot have your care needs met in any other place other than a hospital and require long-term complex clinical care then your care needs will be met, free of charge. The Scottish Government guidance states that if someone has a health need then the NHS will still be responsible for meeting that need, free of charge. However, people in care homes will be asked to contribute (subject to their financial circumstances) towards their social care and accommodation costs.

Only those who need to be in hospital or Specialist NHS Unit will be exempt from charges relating to their accommodation. Everyone else, whatever their age or disability should contribute to the funding of accommodation costs, following a financial assessment. The Scottish Government has identified that it is better for care to be delivered so that more people with ongoing clinical needs can receive treatment better suited to their needs in the community rather than a hospital as soon as it is safe to do so. Receiving long-term care In hospital should be the last resort.

Who is eligible for Hospital Based Complex Clinical Care?

Anyone who is in hospital is eligible to be assessed for Hospital Based Complex Clinic Care. The aim is for hospital patients not to be in hospital for longer than necessary and to ensure that they are placed in the most suitable environment with the best care suited to their needs.

Who decides about Hospital Based Complex Clinical Care?

An assessment will be carried out by a consultant or equivalent specialists, helped by the multidisciplinary team. The assessment should be carried out in partnership with you and your family and your carer. Your wishes and views will be taken into account. The assessment will help to establish the best place to have your clinical healthcare needs met. The assessment for long term complex clinical care is now based around the one question 'Can the individual care needs be properly met in any other setting other than a hospital?'

An independent review of adult social care in Scotland was published in February 2021, following these recommendations Scotland launched a consultation of a national Care Service for Scotland, setting proposals to improve the delivery of social care.

If the answer is no then you will be eligible for Hospital Based Complex Clinical Care.

If the answer is yes then you will be discharged from the NHS care and placed in a suitable community setting, such as at home with support, supported accommodation or a care home and you may have to contribute towards the cost of your care. Contact your local council and ask them to carry out a financial assessment to find out how much, if anything, you need to contribute towards.

Discharge from Hospital

Where is has been assessed that you do not require Hospital Based Complex Clinical Care then a multidisciplinary team of health and social care staff will assess your needs before developing a discharge plan for you. This process will identify the services and support you may need when you leave hospital. If you do have some concerns about being discharged from hospital and your right to Hospital Based Complex Clinical Care then you should ask the hospital if there is someone you can speak to for advice and support. You may also wish to ask for an advocate to speak on your behalf.

Discharge to a Care Home

If after you have received your assessment and it has been identified that your care needs are best suited at a care home then you have a right to a care home of your choice.

Your assessment will inform you the most suitable home that will best suit your needs. You can choose up to three homes from the homes identified and you can confirm which your preferred homes are. At least one of your choices should have a vacancy available for you at the time of your discharge. Your social worker will be able to let you know which homes have rooms available. If your preferred does not have any available rooms then you will temporarily move to another suitable home with a vacancy until there are rooms available in your first choices. Your name will be added to the waiting list and your social care worker will make you aware when a room in your first choice is available and if you still want to move to this care home then this will be arranged for you. You may be asked to contribute towards your care home fees. Your local authority will carry out a financial assessment, this will include looking at your income, savings and/or investments and then will decide how much you will need to contribute towards your care.

All care homes in Scotland are registered and regulated by the Care Inspectorate Scotland (CIS).

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