Will the NHS pay my care home fees?Posted on: 31 January 2014 by 50connect editorial
If you or a loved one are moving into residential care it can be difficult to find out what financial help is out there and if you are entitled to any.
People who have specific medical needs, rather than just personal care needs, may be eligible for some support from the NHS to help fund their care.
What type of NHS support is available?
NHS Funded Nursing Care (FNC) is a contribution towards nursing care costs paid for by the NHS for people who live in a care home with nursing. It is based on medical needs, not ability to pay. You should receive it if you live in a care home registered to provide nursing care and have been assessed as needing nursing care and you don’t qualify for NHS Continuing Healthcare. The NHS will make a payment directly to your care home to fund care from registered nurses who are employed by the care home. This benefit is currently £109.79 per week in England (for the tax year 2013/14). For more information on care home fees, please click here.
NHS Continuing Healthcare is for people who have very complex and unpredictable health needs. If assessed as eligible all care costs are met by the NHS regardless of your financial circumstances. As well as healthcare and personal care, the NHS will pay for your board and accommodation in a care home. You may also receive the care at home. If you are not initially eligible, you can be reassessed for NHS Continuing Healthcare if your health deteriorates.
A joint package of care is when the NHS still pays for some of your care if you are not entitled to either NHS Funded Nursing Care or NHS Continuing Healthcare. This means that the NHS and your local authority may share responsibility for funding the care agreed in your support plan.
How is eligibility assessed?
To assess if you are eligible for NHS Continuing Healthcare, initially, you will undergo an assessment by a health or social care professional using a screening tool called a “checklist tool”. Eligibility does not depend on a specific illness, condition, disability or where the care is provided.
If the screening suggests you may be eligible for NHS Continuing Healthcare, a full up-to-date assessment, using a “decision support tool” will be carried out. This assessment will involve an NHS nurse, at least one representative from social services as well as other professionals involved in your care. Your views about your own care needs will be taken into account, but you may want a friend or relative to be there with you for support when you undergo your full assessment.
The assessment for NHS Funded Nursing Care should be done automatically when someone moves into a nursing home.
What happens next?
Following your assessment, the Clinical Commissioning Group (CCG) will write to you with its decision about whether you qualify for NHS Continuing Healthcare, and explain its findings. If you are eligible, it will discuss with you how your care needs will be managed and where, but if you’re not eligible you can discuss with your local authority whether you might be able to get support from them instead. If you don’t agree with the decision about your eligibility you can ask your CCG to review your case.
For more information on care home funding entitlements and how to pay for care home fees, please visit PayingForCare.
i Ref: NHS
PayingForCare is a national service for those who are faced with paying the cost of their long term care. Our impartial and free-to-use service helps older people, their friends, families and carers access the financial information and advice they need to make informed choices.
We work closely with care providers, local authorities, government departments, charities, health services, support organisations and other experts in the care sector to address this complex subject and ensure financial information and advice is readily available.
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