NHS continuing healthcare

It's often difficult to know what you're entitled to when it comes to health care needs as we get older.  Recent guidelines on care homes, issued by the Competition and Market Authority, set out responsibilities of care homes and consumer law rights. But it can still all seem a little daunting.

If you’re struggling to cope with any part of the continuing healthcare process, or if you would like to know how it might affect you or a loved one legally, you can speak to First4Lawyers and benefit from our team’s wealth of expertise.

There are various ways an experienced healthcare solicitor can help to relieve the burden if you’re applying for continuing healthcare funding, and First4Lawyers can help you as you work to secure funding for individuals with primary health needs.

What is NHS continuing healthcare?

NHS continuing healthcare, also known as fully funded NHS care, is funding that the NHS provides to people who are assessed as having a primary health need. If you or someone you know requires full-time care for health reasons, they could be eligible for NHS continuing care.

It covers all fees for people who are in a care home, including the cost of accommodation, as well as all nursing care and household costs related to care needs.

Continuing healthcare (CHC) is not means tested, meaning anyone who applies will be assessed on the basis of their health, rather than their financial situation.

Who is eligible for NHS continuing healthcare?

The NHS takes responsibility for a person’s care requirements when those requirements are deemed to be primarily related to the individual’s health.

There are many reasons why people move into care homes, including struggles with mobility, or difficulty in carrying out essential daily tasks. In most cases, the provision of accommodation and care is funded by the individual, with contributions from social services and local authorities where relevant.

Where the reasons for requiring nursing and care are primarily related to a person’s physical or mental health, the NHS may take responsibility for providing funding.

To access NHS continuing healthcare funding, you will need to prove that your needs are:

• Not of a kind usually managed and provided for by social services.
• Not incidental and ancillary to the accommodation and care that social services can provide.
• Complex, intense or unpredictable.

Proving your eligibility can be a difficult process, and people may struggle to access NHS continuing healthcare funding, even when they have a watertight case.

I wish to challenge an NHS care home funding decision – what should I do?

NHS continuing healthcare applications are rejected for a variety of reasons, and mistakes can be made during the assessment and appeals processes.

As such, it is often possible to successfully challenge NHS care funding decisions and reclaim the fees the NHS are obliged to cover.

Specialist solicitors from First4Lawyers can review your specific circumstances and help you to establish whether you have a strong case to make a claim for fees.

Care home funding decisions can also be challenged retrospectively, and if you believe a relative has died, after wrongly paying fees that should have been covered by NHS continuing healthcare, we can help you to work towards the recovery of those fees.

Whether you are just embarking on the process of applying for NHS continuing healthcare, or if you are seeking to recover funding owed to you, you can talk to First4Lawyers.

We can establish the best course of action and advise you on the next steps to take.