NHS Funding For Care Home Fees15th Aug 2023
Paying For Care Home Fees
Paying for care in later life has become increasingly more challenging as sweeping demographic changes take effect. More of us are living into our 80s and requiring more nursing care.
Local authorities will fund care and nursing home fees only if a person’s assets fall below a threshold of £23,250.
Councils can deny funding if they think you have concealed savings, investments or other assets. They take a dim view of people who deliberately impoverish themselves by giving away assets to family or friends.
Alternatively, the National Health Service can provide fully funded care through its NHS Continuing Healthcare programme.
But in either case, it pays to seek specialist legal expertise before you apply for funding. The legal fees can be far outweighed by the huge sums of money you could save.
What Is NHS Continuing Healthcare?
NHS Continuing Healthcare is fully funded care for people with complex ongoing health issues that go beyond the help that GPs or community services can provide.
This covers the cost of medical and nursing care, therapy and personal care in various settings including:
- care homes
- nursing homes
- your own home.
Significantly, this funding isn’t means-tested: it is not restricted to people on a low income or with few assets.
To be eligible for NHS Continuing Healthcare, a person’s primary requirement must be on the basis of health – not social care.
The individual’s care needs must be related directly to their health condition, rather than their social or daily living requirements.
In each case, healthcare professionals will conduct a comprehensive review to assess eligibility for funding. The reviews are carried out by NHS Integrated Care Boards.
What Are NHS Integrated Care Boards?
There are 42 Integrated Care Boards in England. Each is responsible for:
- planning for the health needs of its local population
- managing NHS budgets
- arranging the healthcare accordingly.
These boards are part of the NHS’s Integrated Care System (ICS). They were established on 1 July 2022 as part of the Health and Care Act 2022, replacing the old Clinical Commissioning Groups (CCGs).
How Can I Obtain Continuing Healthcare Funding?
To gain funding, you need to qualify following a Continuing Healthcare assessment by your Integrated Care Board.
Most applications fail. Some 77.73% of the 48,591 Continuing Healthcare assessments between April 2022 and the end of March 2023 failed.
To succeed, you will need to understand the NHS’s 187-page rulebook: the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care.
You must be able to challenge NHS healthcare professionals on the basis of the:
- health issues at stake (rather than on social care)
- correct interpretation and application of the guidance.
If you can prove that members of the team which carried out the assessment fell short of their professional standards by failing to follow the National Framework correctly, then you may have a chance of gaining funding for NHS continuing care.
However, one glance at the National Framework will probably tell you that this is a job best done by an expert.
Get Expert Legal Advice
Contact Coles Miller disputes and litigation solicitor Shan Hounsell for specialist legal advice on care funding claims.
Shan has extensive litigation experience in both the public sector and private practice. She is based at our Poole head office.