NHS Continuing Healthcare
If your or your loved ones main care need is classed as a ‘health’ need rather than an ongoing need for care because of, say, general frailty, the NHS is responsible for providing fully funded care - wherever a person lives, whether that’s a care home or their own home.
Eligibility
Anyone over 18 who has a need for continuing care resulting from disability, accident or illness which cannot be satisfied by ordinary NHS services alone can apply for NHS Continuing Healthcare.
Who will in practice be successful in obtaining NHS Continuing Healthcare is an impossible question. Budgetary pressures mean most applications are refused. It is probably true to say to get NHS Continuing Healthcare means you will have to research your case diligently and argue it persistently.
See also Which for more information about challenging a decision.
How do I get it?
- Ask your doctor or social worker to arrange an assessment.
- The next step is an initial screening. A nurse, doctor or social worker will assess care needs using a checklist covering these things. The purpose of the initial screening is to decide whether your case is strong enough to proceed to a full assessment.
- If your case is deemed strong enough you will go forward to a second assessment. This is performed by two health care or social care professionals. Using the same checklist as the first assessment they will rank care needs in each area as low, moderate, high or severe. Click here for a description of how serious care needs must be to qualify for NHS Continuing Healthcare.
- If you are refused NHS Continuing Care you can ask your local Clinical Commissioning Group, Health Board or Social Care Trust to review their decision. If is was based on an initial assessment alone you can ask for a full assessment, and if it was based on a full assessment you can see all the evidence that was taken into account and contribute new evidence. You must do this within six months of the original decision.
Personal Health Budget
People living in England who succeed in obtaining NHS Continuing Healthcare can choose to receive their assistance in the form of a Personal Health Budget. Obviously this gives you extra flexibility because you decide how to spend the money, but, at the same time, you get the added burden of having to research exactly what services are available in your area and ascertain which service providers offer the quality you want.
NHS Funded Nursing Care
If your application for NHS Continuing Health Care is unsuccessful you may be eligible for NHS Funded Nursing Care. However this only applies to people who reside in care homes registered to provide nursing care and is unavailable to people living in their own homes.