Continuing Healthcare assessment: Am I eligible for NHS funding?

    Continuing Healthcare assessment: Am I eligible for NHS funding?

    This summer, the NHS celebrated its 70th birthday. This was a chance to celebrate its achievements and appreciate the vital role that this service plays in our lives.

    A key role not always emphasised is the care of our elderly. Not just those admitted to hospital but also those who have primarily health care needs and who are eligible for funding for a full package of care.

    What is CHC (Continuing Healthcare) funding?

    CHC funding is a valuable service provided for by the NHS that far too many families are unaware of. Not only is it not means-tested, but it is also available for those with eligible needs to fund the entire package of their care.

    Is Continuing Healthcare means-tested?

    In order for a person to qualify they must have primarily healthcare needs which are above and beyond that which the Local Authority is expected to provide for. Eligibility is determined initially by a Checklist assessment and, if this is positive, by a more detailed assessment called a Decision Support Tool (DST).

    Does it matter whether I have savings and/or a high income?

    The answer is simply no! CHC funding is not means-tested and should be assessed for before any questions are asked about your finances.

    Do I need to disclose my finances to Social Services if I am being assessed for CHC funding?

    No. As above, CHC funding is not means-tested and should be assessed for before any questions are asked about your finances.

    What is the time frame from the Checklist assessment to completion of the DST and an eligibility decision?

    National Framework timescale is 28 days from receipt of the Checklist however there are no meaningful shortcuts unless the individual circumstances are such that a Fast Track application should be submitted.

    There is not a great deal of merit in writing repeated letters to the Clinical Commissioning Group (CCG) complaining about the timescale as the response, if any, will be a lack of resources.

    However, if you have run out of funds and the care package is insufficient then it will be important to put the responsibility back to the NHS and or Social Services to interim fund until a NHS CHC decision is made.

    What is Fast Track Funding?

    This is a tool used when an individual requires immediate access to an urgent package of CHC due to a rapidly deteriorating condition that may be entering a terminal phase, and has an increased level of dependency.

    What is Funded Nursing Care (FNC)?

    NHS FNC is care provided by a registered nurse for people who live in a care home. The NHS will pay a flat rate contribution directly to the care home towards the cost of this nursing care.

    You may be eligible if:

    • you are not eligible for NHS Continuing Healthcare but have been assessed as needing care from a registered nurse
    • you live in a care home registered to provide nursing care

    How will my needs be assessed for Funded Nursing Care?

    You should be assessed for NHS Continuing Healthcare before a decision is made about whether you are eligible for NHS FNC.

    What is the rate of payment for NHS Funded Nursing Care?

    In April 2018, the rate was set at £158.16 a week.

    Before October 1 2007, there were three different levels or bands: low, medium and high.

    If you moved into a care home before October 1 2007, and you were on the low or medium bands, you would have been transferred to the standard rate from that date.

    If you moved into a care home before October 1 2007, and you were on the high band, NHS FNC is paid at a higher rate. In April 2018, the higher rate was set at £217.59 a week.

    You’re entitled to continue on this rate unless:

    • you no longer have nursing needs
    • you no longer live in a care home that provides nursing
    • your nursing needs have reduced and you’re no longer eligible for the high band, when you would change to the standard rate of £158.16 a week, or
    • you become entitled to NHS Continuing Healthcare

    We can help you

    Our recent success includes an application for wrongly charged care fees dating back almost three years, leading to a refund of more than £100,000. With care costs escalating, a simple call to one of our advisors could mean that care fees are not wrongly paid in the first instance, avoiding unnecessary financial hardship for many families wanting the best possible care for their loved ones

    For further advice on care funding options or to assist with the process, please do not hesitate to contact our team who will be happy to help.

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