Care terms and professionals explained

Why Knowing the People Matters as Much as Knowing the Rules

When a family member needs care, understanding the funding rules is only half the challenge. The other half is understanding who does what. A hospital discharge assessor is not the same as a CHC assessor. A social worker is not the same as a safeguarding lead. An occupational therapist and a physiotherapist may both assess the same person but for entirely different purposes. Getting these roles confused can lead to missed referrals, delayed assessments, and missed funding that a family was entitled to all along.

This jargon buster is designed to help families, carers, and anyone navigating the care system understand who each professional is, what they are responsible for, and when to involve them. It covers everyone from the GP who starts the process to the IMCA who protects the rights of people who cannot speak for themselves.

The NHS and Local Authority Split

Most of the professionals in this guide fall into one of two systems. NHS professionals including GPs, community nurses, physiotherapists, occupational therapists, and CHC assessors are employed or commissioned by the NHS and their involvement is free at the point of need. Local authority professionals including social workers, safeguarding leads, and activities coordinators are employed or funded by the council. In practice the two systems overlap significantly: a hospital discharge might involve an NHS discharge assessor, a council social worker, and a community OT from an NHS trust all working on the same case.

Understanding which system a professional belongs to matters because it determines who pays for their time, who they report to, and what decisions they can make. When things go wrong or there are disputes about care, knowing this structure helps families identify who is accountable.

The role of CHC assessors in particular

Of all the professionals listed in this guide, CHC assessors have perhaps the most significant financial impact on a family. Their recommendation to an Integrated Care Board about whether someone qualifies for NHS Continuing Healthcare can be the difference between a care bill of hundreds of thousands of pounds and no bill at all. Families should understand that CHC assessors make a recommendation, not a final decision; the ICB makes the funding decision. If the recommendation or decision seems wrong, it can be challenged via the Local Resolution process and, if necessary, an Independent Review Panel.