NHS Continuing Healthcare – are you being deprived?

NHS 2There was such a response to my previous article on NHS Continuing Healthcare that I thought it would be helpful to go into more detail. Almost everyone I spoke to said that the only assessment that had been carried out was a financial assessment which had sorted out how much they needed to pay for the care!

The disappointing thing is that all these people didn’t realise that such a ‘financial assessment’ should not have taken place. The lack of knowledge and understanding is not their fault. Hundreds of families report that the health and social care authorities often omit to explain the actual criteria for care funding and that not all care is the same. Unfortunately, many medical and social services staff don’t understand the criteria themselves. In addition, media articles, and also sometimes well-meaning friends, often promote the notion that you have to be means tested and pay for care if you have savings or a house. This is not true.

Whether or not you pay for care does NOT depend on your money or whether you have a house. It depends on your care needs only.


How care funding works

So let’s break things down as there’s a very simple ‘divide’:

  • Local authorities/councils provide social care which is means tested.
  • The NHS provide healthcare/nursing care, which is not means tested. It’s the difference between these two things that is at the heart of care funding assessments and it is also at the root of almost all disputes about NHS Continuing Healthcare funding. Just because you may be older and just because you may be living in a care home or other care environment (including your own home), doesn’t change your right to NHS care. After all, if you go to A&E or to see your GP, they don’t generally debate with you how much they’ll do and what you might have to pay them to finish the job. It’s no different when you need care. If your needs are of such a level that you require NHS care, then you should receive NHS funding to pay for all your assessed care needs.

Here’s a typical scenarioYou need care, and so: Local authorities have a duty to carry out an assessment of needs… (as detailed by the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care). This does not mean a financial assessment or a means test. It’s an assessment of actual care needs. At this point no one should ask about your money or your house. The next question is: Which side of the local authority or NHS divide do your needs fall into? If it’s the social care side, you are means tested. (Alternatively, you can simply pay – you don’t have to undergo a financial assessment). However, if your care needs are primarily on the NHS side of the divide, the NHS has a legal duty to pay for your care and this covers all your assessed care needs PLUS the costs of living in a care home. You should not be asked to contribute to this. This funding is called NHS Continuing Healthcare. There should be no financial assessment, you should not be means tested. But, if you have some healthcare/nursing care needs and also some social care needs, how do you know which side you’re on? It’s simple: It’s through an assessment for this NHS Continuing Healthcare funding. Local authorities must refer you for a Continuing Healthcare assessment if there is even a small indication you could be eligible for this.

  • Remember, this is not a means test or financial assessment; it’s an assessment for full NHS funding. Your money has nothing to do with it and you should not be asked anything about your savings, assets, pension, house or any other money you may have.
  • No one can tell you whether or not you have to pay for your care (i.e. which side of that divide you’re on) until this has been done.

To read the original NHS Continuous Healthcare blog post click here…

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