NHS Continuing Health Care
NHS Continuing Health Care (CHC) funding is available for elderly people who are assessed as having a “primary health need”. If approved for Continuing Health Care funding all Home Care visit fees and Care Home fees will also be paid by the NHS.
In simple terms a “primary health need” can be defined as having ongoing significant physical and/or mental health needs and taking into account all care needs, it can be said that the main aspects or a majority part of the care need is focused on addressing and/or preventing health needs.
The existence of NHS Continuing Health Care funding is very sparsely publicised. Home Care visit fees cost from around £750 to over £4,000 a month and Care Home fees cost around £6,000 a month. The lack of publicity surrounding the availability of NHS Continuing Health Care funding may be linked to the chronic funding crisis within the NHS.
Home Care visits and Care Home admissions are managed by the Social Services department within Councils and are paid for by the person receiving care. However, the same Home Care visits and Care Homes arranged through NHS Continuing Health Care funding are completely free.
In simple terms a “primary health need” can be defined as having ongoing significant physical and/or mental health needs and taking into account all care needs, it can be said that the main aspects or a majority part of the care need is focused on addressing and/or preventing health needs.
The existence of NHS Continuing Health Care funding is very sparsely publicised. Home Care visit fees cost from around £750 to over £4,000 a month and Care Home fees cost around £6,000 a month. The lack of publicity surrounding the availability of NHS Continuing Health Care funding may be linked to the chronic funding crisis within the NHS.
Home Care visits and Care Home admissions are managed by the Social Services department within Councils and are paid for by the person receiving care. However, the same Home Care visits and Care Homes arranged through NHS Continuing Health Care funding are completely free.
Proving an elderly person’s reason for needing care is a “primary health need” which is paid for by the NHS, rather than a “social care need” which is paid for by the person receiving care under the terms of the Care Act 2014 can be challenging.
People can ask to be assessed for NHS Continuing Health Care funding by contacting the NHS, Social Services or their local Integrated Care Board (ICB). However, people are often dissuaded from pursuing an application for NHS Continuing Health Care funding simply by NHS staff or Social Services telling them they feel the care need is not a “'primary health need'.
People are also dissuaded from continuing to pursue an application for NHS Continuing Health Care funding because the person needing care fails a basic “Checklist Assessment” and is therefore not entitled to a “Full Assessment” or if they fail a “Full Assessment”. However, both of these decisions can be successfully appealed through the local Integrated Care Board and if rejected through the Parliamentary and Health Service Ombudsman.
NHS England estimates that of those who apply for NHS Continuing Health Care funding and receive a basic “Checklist Assessment” only 24% are approved to receive a “Full Assessment”. NHS England also estimates that of the people who receive a “Full Assessment” 68% of people diagnosed as entering the “terminal phase” of their lives and 6.6% of others are approved for NHS Continuing Health Care funding.
Elderly people are often too respectful of authority figures or too ill to argue that they are entitled to receive NHS Continuing Health Care funding. However, an elderly persons Attorney is often in a far better position to pursue a successful application for NHS Continuing Health Care funding on behalf of their elderly family member.
If at any time during the assessment or appeal process NHS staff or Social Services decide the person applying for NHS Continuing Health Funding has lost Mental Capacity, it will be too late to put into place a Power of Attorney. If a Power of Attorney is not in place family members are likely to find it more difficult to successfully pursue a claim for NHS Continuing Health Care funding. Therefore, it is important a Power of Attorney is put into place before an application for NHS Continuing Health Care funding is made.
People can ask to be assessed for NHS Continuing Health Care funding by contacting the NHS, Social Services or their local Integrated Care Board (ICB). However, people are often dissuaded from pursuing an application for NHS Continuing Health Care funding simply by NHS staff or Social Services telling them they feel the care need is not a “'primary health need'.
People are also dissuaded from continuing to pursue an application for NHS Continuing Health Care funding because the person needing care fails a basic “Checklist Assessment” and is therefore not entitled to a “Full Assessment” or if they fail a “Full Assessment”. However, both of these decisions can be successfully appealed through the local Integrated Care Board and if rejected through the Parliamentary and Health Service Ombudsman.
NHS England estimates that of those who apply for NHS Continuing Health Care funding and receive a basic “Checklist Assessment” only 24% are approved to receive a “Full Assessment”. NHS England also estimates that of the people who receive a “Full Assessment” 68% of people diagnosed as entering the “terminal phase” of their lives and 6.6% of others are approved for NHS Continuing Health Care funding.
Elderly people are often too respectful of authority figures or too ill to argue that they are entitled to receive NHS Continuing Health Care funding. However, an elderly persons Attorney is often in a far better position to pursue a successful application for NHS Continuing Health Care funding on behalf of their elderly family member.
If at any time during the assessment or appeal process NHS staff or Social Services decide the person applying for NHS Continuing Health Funding has lost Mental Capacity, it will be too late to put into place a Power of Attorney. If a Power of Attorney is not in place family members are likely to find it more difficult to successfully pursue a claim for NHS Continuing Health Care funding. Therefore, it is important a Power of Attorney is put into place before an application for NHS Continuing Health Care funding is made.