Children’s Continuing Care (CCC) in the UK
Children’s Continuing Care (CCC) is a non-means-tested NHS framework providing a tailored package of support for children and young people (under 18) with complex health needs that cannot be met by existing universal or specialist services. Eligibility is based solely on healthcare needs.
Who’s Eligible for CCC?
Eligibility is determined by a comprehensive assessment of a child’s health needs. Children who are likely to be eligible often have:
Severe, complex, or unpredictable healthcare needs.
Dependency on technology, such as a tracheostomy, home ventilation, or long-term parenteral nutrition.
High-risk of sudden deterioration or hospital admission without continuous skilled care.
The need for frequent interventions from skilled carers, for example, frequent suctioning or complex seizure management.
This often includes children with profound neurodisability, life-limiting conditions, or multiple complex comorbidities.
The Assessment Process
The CCC assessment is a structured, multi-step process:
Referral: A healthcare professional (often a paediatrician, community nurse, or allied health professional) or the family can initiate the referral.
Multidisciplinary Team (MDT) Input: A Decision Support Tool (DST) is used to gather detailed evidence across ten care domains (e.g., breathing, nutrition, mobility, behaviour, communication, medication, consciousness). The DST helps to quantify the intensity, complexity, and unpredictability of the child’s needs. The assessment draws on information from all relevant professionals, including paediatricians, therapists, nurses, and teachers.
Recommendation and Panel Decision: A lead assessor, typically a specialist CCC nurse, synthesises the MDT evidence. This is then reviewed by a commissioning panel to determine if the child is eligible for an NHS-funded package of care.
Package of Care: If eligible, a personalised care plan is developed, funded, and reviewed regularly to ensure it still meets the child’s needs.
The Paediatrician’s Role
Paediatricians play a pivotal role throughout the process:
Identifying children who may qualify and initiating referrals.
Providing clear, comprehensive medical evidence including diagnoses, prognosis, and the rationale for required interventions. Your medical opinion is crucial for accurately describing the child’s health needs and associated risks.
Collaborating with the MDT to ensure a holistic view of the child’s needs is captured.
Supporting families by explaining the process and setting realistic expectations, as the assessment can be complex and emotionally challenging.
Why CCC Matters
CCC is a cornerstone of community-based paediatric care. It’s a key mechanism for:
Ensuring equity by providing structured NHS support to children with the most significant health needs.
Empowering families to safely care for their child at home, avoiding unnecessary and prolonged hospital stays.
Improving a child’s quality of life by ensuring their complex needs are met in their own environment.
Reducing avoidable hospital admissions and promoting care closer to home.