Care Act - Continuing Healthcare (CHC) Interface in the context of hospital discharge... 19 October 2026

Course title: Standing Up for CHC Rights: The Care Act - Continuing Healthcare (CHC) Interface in the context of hospital discharge & community-based clients

Audience

Local authority adult social care staff, hospital social work teams, discharge coordinators/nurses, transfer of care hubs, advocates, legal teams and ICB partners involved in CHC, discharge planning and funding decisions

Aims

By the end of the day participants will:

• Understand the legal interface between Care Act duties and the National Framework for NHS Continuing Healthcare, including the concept of primary health need and public law constraints on ICB rationing.

• Be able to recognise unlawful or risky local practices around CHC withdrawal, “step‑down” arrangements and discharge, and know how to challenge them lawfully.

• Have a repertoire of scripts and written phrases to use with ICBs, ward staff, providers and families when standing up for clients’ CHC and Care Act rights.

Learning outcomes

Participants will be better able to -

• Explain the difference between individuals’ enforceable rights to care/support and the NHS’s obligations to provide health services, including the limits of “policy‑based” restriction of CHC.

• Apply the “primary health need” test and distinguish CHC, FNC, reablement, intermediate care, respite and step‑down pathways in discharge planning.

• Identify “wrong turns” in CHC process (checklisting, Fast Track misuse, reviews vs revisions, consent and best interests) and use targeted challenge scripts at each stage.

• Spot unlawful discharge decisions in relation to CHC/Care Act rights, and use scripts to resist unsafe, procedurally unfair or financially‑driven discharge plans.

• Describe governance obligations around follow‑up, re‑assessment and bed‑blocking, and articulate lawful “bed‑blocking solutions” when CHC is in issue.

Programme and timings (9.30–16.30)

Teaching methods and format

• Lecture input, case studies, quiz, script‑writing exercises and group discussion, with a strong focus on applying law to real‑world CHC withdrawal scenarios

Introduction and context (9.30–10.00)

• Introductions, aims, ground rules, overview of the day, leading into a shared picture of current ICB strategies and positioning.

The legal line: Care Act vs NHS duties (10.00–11.00)

• How the line between “care and support” and “healthcare” works in law and practice; recap of primary health need and its significance for funding.

• Public vs private law principles relevant to CHC and discharge; where the Discharge to Assess guidance “hides” two decades of legal developments.

Break (11.00 – 11.15)

CHC process risks and appropriate responses (11.15–12.15)

• Key concepts in CHC process: checklists, Fast Track rights, and the impossibility of a rigid “line”.

• Typical wrong turns and non‑compliance: well‑managed need, MDT disagreement handling, nurse co‑ordinator “errors of law”

• Distinguishing reablement/intermediate care from step‑down or respite, why labels matter for charging and CHC consideration.

Script workshop: (12.15 – 12.45)

• Phrasing to use in professional discussions -  dealing with pressure to accept unsafe or unlawful transfers; non-existent checklists or nursing needs assessments, Fast Track refusals, and “review”‑ based withdrawal of NHS- funded interim services;

• Draft wording for recording dissent and preserving public law remedies in case notes and emails and defensible “reason for delay” entries and escalation emails to senior managers/hub/ICB leads

• Phrasing for multi-disciplinary team meetings and panel process.

Lunch (12.45–13.30)

Governance, follow‑up and lawful “bed‑blocking solutions” (13.30–14.15)

• Governance obligations around follow‑up, CHC review, and Care Act assessment after discharge or after CHC decisions or withdrawal.

• What the law says about “bed‑blocking”;  how councils and ICBs should share responsibility, and what must not be done if managing legal risk properly.

Case vignettes and application (14.15-14.30)

• Exploring 2 case vignettes for hospital discharge and community-based clients drawn from decided case law on CHC and discharge, crafted to reflect current ICB withdrawal tactics

Break (14.30 – 14.45)

Group work (14.45 – 15.45)

• Mapping the scenarios to the Framework and the Care Act; identifying points for intervention and choosing appropriate challenge scripts for each.

Quiz, reflection and close (15.45–16.30)

• Online multi‑choice quiz testing understanding of Care Act–CHC interface, discharge pitfalls and lawful challenge points.

• Individual action planning: each participant drafts 3 new scripts or stock phrases to take back to practice; plenary feedback, final questions, evaluations and close.

The course will be delivered by Belinda Schwehr

Belinda is a well-known legal framework expert and trainer, known for her passionate delivery about legal literacy and the need for public sector staff to remain up-to-date in the public law principles which govern their day-to-day work. She was awarded ‘Change Agent in Adult Social Care’ in Care Talk’s 2022 ‘Women Achieving Greatness’ Awards.

She worked as a trainer for public sector staff full time 2003-2018, after practising as a barrister and then as a local government and social care solicitor. In 2018 she founded and has been running CASCAIDr, a specialist legal advice charity with a mission to uphold people’s public law rights.

Belinda’s special area of expertise is the Care Act and its interface with the Mental Capacity Act and the wider legal frameworks underpinning Continuing NHS Healthcare, and s117 of the Mental Health Act. She covers assessment, eligibility, care planning and cuts, choice of accommodation, direct payments, safeguarding, commissioning, charging and complaints. Her publicly available output on the centrality of public law principles is available on YouTube.

She has given oral and written expert evidence to the House of Lords’ Select Committee on the invisibility of social care and to the EHRC’s enquiry on routes for challenge in adult social care. In 2020-21 she provided regular live comment to radio and TV programmes (You and Yours, Today, CoProduceCare and GB News) and appeared regularly on CoProduceCare’s livestream events on the Care Act Easements and the inadequacies of policy and logistics regarding public bodies’ MCA compliance, and support of the care home sector, during Covid-19.

In the previous decade, she worked with ADASS on the lawful delivery of personalisation (Putting People First: a DH initiative). She also supervised, for ADASS, the production by a law firm of an early form of national Commissioning Guidance for councils. In 2007 she was grant funded by the Department of Health to put on a Mental Capacity Act awareness-raising podcast and developed her own e-learning package, one of the earliest of the form attempting to teach professional judgment, which was taken up by 25 authorities for use potentially for 10,000 staff and individuals in each authority. She completed an additional module on DoLS, in 2009, rightly predicting that the Government’s ambiguous guidance as to what constituted deprivation of liberty could not possibly be sufficient to withstand judicial scrutiny.

All Event bookings must be made online with payment made in full by credit / debit card.  We do not send invoices/use Purchase Order numbers for Event bookings for NHS delegates  (this policy does not affect our commissioned bookings)

Course access details will be emailed direct to delegate(s) upon completion of your booking.  

Includes all course materials and a certificate. If you have any queries, please do not hesitate to email events@edgetraining.org.uk  or call 07341 277487.