NHS Continuing Healthcare is a form of funding provided by the NHS to pay for a patient’s care costs in full where it is the case that the patient’s need for care is primarily a health need. This means that their needs are deemed to be sufficiently intense, complex or unpredictable in their nature that they go beyond standard social care needs and are a primarily health need.
Once this is established the NHS are required to pay for the clients care costs in full, whatever their location. As such it will pay for their care if they are in a residential care home, at home being cared for with carers or in a nursing home.
Why have I not been told about it?
Whilst it is the case that the law and the process for assessing for Continuing Healthcare Funding are very clear and the process is a good one, it is sadly often not carried out correctly or even carried out at all.
A person should be assessed for Continuing Healthcare Funding as a first stop in the process of determining if they should be paying for care. There should be no discussions at all on what the patient’s financial situation is until it has first been established if their need for care is a health need or not. If it is the case their needs are health needs they are entitled to Continuing Healthcare Funding and their costs should be paid in full by the NHS. It is irrelevant what the patient’s financial situation is and has no bearing whatsoever on the decision.
Can I just ask for my relative to be assessed for Continuing Healthcare?
Anyone can ask for an assessment to be carried out for a patient to establish if there is an entitlement to Continuing Healthcare Funding. The issue is whether the assessment will be undertaken even when it has been requested, and secondly if it is carried out if the patient’s needs will be correctly assessed.
A large number of cases where a Continuing Healthcare Funding assessment have been undertaken will result in a patients’ needs being incorrectly assessed and they are denied funding for Continuing Healthcare when in fact it should have been awarded to meet the patient’s care costs in full. This is beyond dispute. The National Audit Office, (the UK’s independent public spending watchdog) has previously undertaken reviews of the Continuing Healthcare Funding and advised that in around one third of appeal cases presented to NHS England a decision was made to overturn the original decision to deny funding to a patient when they were assessed. This demonstrates a high percentage of patient’s are being incorrectly denied funding when they are assessed for Continuing Healthcare.
As a result, our belief is that the best approach to ensure the highest prospects of success of securing Continuing Healthcare Funding is to be proactive. Our expert team of non-practicing lawyers and medical consultants gather all the available evidence in the form of medical and care records and use the same to present a comprehensive case outlining why, evidentially, the criteria for Continuing Healthcare Funding is met. It is unfortunate and frustrating that the NHS Continuing Healthcare Funding team cannot be relied upon to accurately and fairly assess an individual’s entitlement to Continuing Healthcare Funding, but the facts presented by the National Audit office are clear in that a high proportion of individuals in the period they assessed were incorrectly refused funding. Our belief is that having an expert in your corner affords the best chance of success of securing the funding if the patient is entitled to it.
Why do I need an expert to help me with Continuing Healthcare?
As outlined above it is imperative to have an expert fighting for you who understands the ins and outs of the process and the rules governing Continuing Healthcare Funding. There is no other area of life where there is so much at stake, in this instance having to pay tens of thousands of pounds of care fees a year, where you would not instruct an expert to assist you. Continuing Healthcare should be no different.
Our unique team of qualified non-practicing lawyers are legal and specifically Continuing Healthcare Funding experts. It is all that we do and we do it with a great deal of success and have many happy clients would can testify to the same. We additionally have the benefit of the support where needed of our team of senior medical consultants. Our team includes a consultant neurologist, a general and acute emergency medicine Doctor, a senior clinical pharmacist and a highly experienced Registered General Nurse. This team is unmatched and is not replicated in any other setting any other company or law firm undertaking Continuing Healthcare Funding work. We are truly the experts you need on your side.
Why has my relative not been provided with Continuing Healthcare Funding?
As you are aware first hand the cost of care is exceptionally expensive and these costs only increase the greater the care needs of the patient. We are experiencing clients contacting us to say they are paying care costs in specialist dementia homes with weekly costs exceeding £2500 a week. When costs are amounting to in excess of £130,000 a year and rising it is clear to see why anyone will struggle to meet them and this includes the NHS.
NHS England has previously directed that it required Integrated Care Boards to make savings of £855 million pounds against its Continuing Healthcare Funding spend. With an aging population with greater life expectancy and an increasing instance of issues such as dementia it is difficult to understand how any savings to Continuing Healthcare Funding spending can be achieved . What we do know is that between 2016 and 2017 the number of people assessed as being eligible for Continuing Healthcare Funding DECREASED by 6%.
Combining this with the evidence that NHS England overturned around 30% of decisions on appeal in a similar period, it is clear that the figures demonstrate that funding is being restricted. The process and eligibility criteria has not changed at any time.
What can I do?
If you have a relative who is paying for care, or who has been advised they will have to pay for care, and they have significant care needs you should not hesitate to contact us. We provide a completely free, no obligation and confidential assessment of the particular needs and health issues of the patient and advise whether we believe there is a basis to say they ought to be entitled to Continuing Healthcare Funding. There is no cost whatsoever for providing you with this service and we will take as much time as you require advising you as to your options specific to you