Continuing healthcare funding is provided to individuals by the NHS to meet the costs of their care in full where it is established that their need for care is primarily a health need. The cost of care, including accommodation and what can sometimes be referred to as ‘board and lodgings’ when in a care home is also included.
NHS Continuing Healthcare funding is NOT means-tested. It is irrelevant what assets the individual holds and whether they exceed the local authority social services means testing limit of funds greater than £23,250.
The key principle relates to the core values of the NHS, which is free healthcare at the point of delivery for all.
Assessment of whether an individual should be paying for care, should be reviewed in this order:
Does the individual have primary health needs?
If an individual has primary health needs, then they are entitled to NHS Continuing Healthcare funding to meet the costs of care in full. They’re not required to pay a penny towards the cost of their care, and it is irrelevant whether they have savings or other financial assets or whether they own a home.
What happens if an individual is not eligible for NHS Continuing Healthcare?
Only once it has been determined that an individual is not eligible for continuing healthcare funding to meet their care should there be any discussion about means-testing. Where it has been determined that an individual’s need for care is not primarily a health need, they will need to complete a financial assessment with the local council which will assess whether they have assets exceeding £23,250, the current local authority threshold.
If they do, then they are not eligible for support or financial assistance from the local authority, and they are obligated to meet the cost of their care, in full, until such a time as their assets fall below the means-testing threshold. If their assets are below this threshold, then that will be the point at which Social Services will intervene and contribute to or meet the cost of their care in full depending on their particular circumstances.
NHS Continuing Healthcare funding and Social Services funding for care are two separate and entirely distinct matters. Social Services funding is means-tested, NHS Continuing Healthcare funding is not.
Every individual in care should be assessed to determine whether their needs are primarily health needs or not. Only once this has been done in full and concluded should it be the case that they are financially assessed for Social Services support with care costs.
Unfortunately, very often individuals are not assessed when in fact, their needs indicate that they are entitled to NHS funding in full.
Equally, a patient may not be entitled to NHS Continuing Healthcare funding at their point of entry to care, but if their health needs were to deteriorate, they might then meet the criteria for full NHS Continuing Healthcare funding. This can only be determined if an NHS Continuing Healthcare assessment is undertaken.
Unsure if you or a loved one qualifies?
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