The decision support tool (DST) is a national tool that has been developed to support practitioners in the application of the national framework for continuing healthcare and NHS-funded nursing care 2022, the national framework.
The tool is a way of bringing together information from the assessment of needs, and applying evidence in a single practical format to facilitate consistent evidence-based recommendations and decision-making regarding eligibility for NHS continuing healthcare.
For more information on this, visit the following government website: NHS continuing healthcare decision support tool guidance - GOV.UK
The decision support tool
The DST is intended to support the process of determining eligibility, and ensure consistent and comprehensive consideration of an individual’s needs.
The evidence set out in the tool should be used by the multidisciplinary team (MDT) to help make a recommendation based on the 4 key characteristics:
Nature
Intensity
Complexity
Unpredictability of needs
The DST requires the MDT to set out the individual’s needs in relation to 12 care domains.
Each domain is broken down into a number of levels, each of which is carefully described. The levels represent a hierarchy from the lowest to the highest possible level of need, and the support required.
Whatever the extent of the need within a given domain, it should be possible to locate this within the descriptors provided. This involves matching, as far as possible, the extent and type of the individual’s specific needs with the descriptor in the DST that most closely relates to them.
This approach should build up a detailed picture of needs and provide the evidence to inform the decision regarding eligibility. However, an exact match will not always be possible and, apart from more obvious cases, the domain descriptor levels will not determine eligibility but merely help inform consideration of the primary health need test using the 4 key characteristics of nature, intensity, complexity and unpredictability. These 4 key characteristics should be applied to the totality of needs.
The process for NHS customers
NHS customers will need to complete a mandatory form. This form can be completed electronically or via a paper copy that gets uploaded into the system.
It would be ideal for the electronic version to be completed rather than a paper copy version so that it can be linked to the patients referral within the system. You can report on the data included within the DST and can view the DST easily on the system where as if a paper copy the data is only uploaded as a document to the system. MDT teams can complete pre work on the DST prior to meeting with the patient as they would with a paper copy.
Follow these simple steps to complete the online form digital support tool:
Click on the CMS tab and then click on Patients.
Click on Search under the patient section.
In the Search field, enter the patients details, then click the Search button.
Click the magnifying glass next to the current patient.
Click on the Referrals tab and click the magnifying glass on a particular referral.
Scroll to the assessments section, and on the assessment listed click on View Assessment Form.
Click the Actions button, and click Complete Assessment Form.
Answer the questions in line with the patients information.
Fill out the answers to the 12 care domains.
If a copy of the paper-based document is needed, and you have completed the referral online, the information will be pulled through onto the digital support tool or the checklist. You can find the copy by going to the assessment, then click on the document link from the field Latest Assessment Form Form Document.
Benefits
The benefits the electronic digital support tool are:
It sits on the patient record and can follow the flow in system.
Data within the DST can be reported on for more depth analysis if required.
No longer need to store paper copies.
Can complete the DST electronically with the patient and can still complete pre work.
Can follow the 28 day clock within the system.
Can see blockers on any DST’s that may breach the 28 day clock.
Managers can view nurse workload and how many DSTs and assessments are being completed.