Is your relative getting their entitlement to 6 weeks’ FREE funded care?
“A couple of weeks ago my Mum was discharged from hospital to a care home. At no time did anybody mention the 6 weeks’ free care. Is it too late to claim it back now?”
- Did you know that if your spouse, relative, friend or person you care for has been discharged from hospital into a care home or other care facility since 1st September 2020 they may be entitled to (at least) the first 6 weeks’ care free of charge?
- If your relative been paying for their care unnecessarily during this period, did you know they could be entitled to a full refund?
These are just some of the issues this blog will address.
COVID Discharge Funding Scheme:
As a result of the ongoing COVID pandemic, the Government put in place emergency funding to help individuals being discharged from hospital into a care home setting, who require funding and support for new or additional packages of care, to help with their recovery and rehabilitation.
Nb: If you already have an existing package of care in place then that will resume upon discharge from hospital if it continues to meet the individual’s needs.
The emergency funding pot was made available from 1st September 2020.
How long is the Discharge Funding available?
This free emergency funding is available for the first 6 weeks, but can be extended – see below.
To help speed up hospital discharge and free up beds for new COVID cases.
To promote recovery and independence until a formal assessment of the individual’s long-term care needs can be carried out.
Incentive to patients:
To make available funding for the initial 6 weeks’ care – free of charge, thereby alleviating the financial stress and burden of worrying how to fund their relative’s initial care placement.
The Government has announced that this emergency funding is set to end on 31st March 2021 (see paragraph 10.13 NHS Hospital Discharge Policy).What next?
It is expected that new arrangements or an extension will be announced shortly, possibly extending the scheme to at least the end of June 2021 and even into September, to be followed by a further review.
Why 6 weeks?
This is to enable the local NHS Clinical Commissioning Group (CCG) to carry out an assessment of the individual’s long-term care needs and to determine how their care should be paid for.
If upon assessment, the individual is eligible for NHS Continuing Healthcare Funding (CHC), then the CCG will pay for all their assessed healthcare and social care needs, plus their accommodation, in full, FREE of charge.
The CCG are mandated to carry our their assessment AND provide their decision as to eligibility for CHC within this 6 week period following discharge from hospital.
What happens after 6 weeks?
The COVID emergency discharge funding stops.
If no decision has been made and notified to the individual (or their representatives) then the local CCG is obliged to continue paying the care fees until that stage has been reached.
If the CCG are slow to carry out the assessment and communicate their decision promptly, then they will have to absorb the ongoing cost of the individual’s care from their own budget after the initial 6 week period. So, you can see that there is clearly a huge financial incentive for CCGs to assess patients and reach a decision quickly. Otherwise, they’ll have to foot the bill for the ongoing care package from their own pockets (or involve the Local Authority to agree a funding strategy until they have complied).
The good and the bad:
The good news is that following discharge from hospital, if your relative lives in an area with a pro-active and efficient CCG, they can expect a relatively quick decision as to eligibility for CHC (free package of care). If the outcome decision is positive, this will be enormously helpful, give families peace of mind and relieve the huge financial burden of having to pay ongoing care fees until formal reassessment takes place.
The risk, of course, is that with so many people being ejected from hospital into care quickly, there is a mounting pressure on CCGs to cope and undertake assessments within the initial 6-week period. Unfortunately, with under-resourcing, appointed CCG assessors could be rushed into an incorrect decision which wrongfully denies the patient of their legitimate right to free NHS CHC Funded care; or conversely, paying for care for those individuals who aren’t in fact eligible at all.
If your relative is not found eligible for CHC upon assessment, then they will be passed over to their Local Authority for means-tested care, and if they have assets, savings or capital over £23,250, will end up paying for their own care (self-funding).
Don’t miss out!
31st March 2021 is fast approaching. If your relative is about to be discharged into care and needs a new or additional package of care, make sure they get their entitlement to 6-weeks’ free funded care.
Emotionally overwhelmed by the realisation that their spouse or relative will not be able to return home after an accident, serious illness, disability or progressive medical condition, then comes the need to find them a suitable caring environment and answers as to how their daily care will be funded. Many families just assume they have to pay for care if their relative has means. Don’t fall into this trap!
We are hearing numerous stories from families reporting that they weren’t told or even aware this free emergency discharge funding was available and their relative has been paying privately for their care quite unnecessarily during the first 6 weeks and beyond. Some are still awaiting an assessment weeks later but are continuing to pay privately. Sometimes this can be an eye-watering £1,000 to £1,500 a week from private means!
We find it staggering that hospital co-ordinator discharge/ teams are not routinely mentioning this pot of available COVID funding to help families upon discharge.
If your relative is about to be discharged from hospital, speak to the discharge co-ordinator and find out more about your rights to free-funded care.
Too many people are self-funding their own care quite unnecessarily!
TIP: Don’t pay for care until your relative has had an assessment for CHC Funding!
If the family have means to pay, the care home manager may omit to mention the availability of COVID emergency discharge funding for the first 6 weeks of care, and some may be quite happy to relieve the family of private funds. This is wrong and in breach of the Government guidance.
Beware! Some care homes just don’t understand the Government guidance or deliberately choose to ignore it. For example, we have heard from one family whose care home manager threatened to evict their elderly, frail parent after the initial 6 weeks’ emergency funding period, if the family didn’t pay the invoices from then onwards! The manager apparently hadn’t realised that COVID emergency funding continues beyond the 6 weeks until the formal CHC assessment has taken place and the outcome decision communicated.
Common misunderstanding – Even some Local Authorities are getting it wrong, too! We have heard of one Local Authority who told a family that their relative will automatically have to self-fund as soon as the 6-week discharge funding comes an end. This is incorrect and must be challenged immediately if this happens to your relative. As above, after the initial 6 week period, the CCG (in conjunction with the Local Authority, as appropriate) must take over responsibility for funding ongoing care until the assessment has been undertaken and outcome notified.
Moving between CCGs?
Be alert! It can happen that upon discharge from hospital, a patient may move between Clinical Commissioning Groups and fall between two stools, with neither discharge team mentioning the availability of COVID discharge emergency funding.
Getting a refund:
A family recently attended an assessment for their relative’s eligibility for CHC and were shocked to learn that COVID emergency discharge funding could have been made available to fund, not only their relative’s first 6 weeks of care following discharge from hospital – but way beyond – as assessment took place many weeks later! They have been told that the CCG will look into making a refund (plus interest, we hope) until they are notified of the outcome decision post-assessment. Of course, if the decision is positive, the CCG will continue to pay for their relative’s care package in full.
Where applicable, ensure that your relative is receiving COVID emergency discharge funding. Remember, at present it only applies to patients being discharged from hospital into care who need a new or additional package of care. If you have been paying care fees in the meantime, request a full refund until the assessment and outcome decision is notified to you. Until then, don’t assume your relative will be expected to pay for their own care.
For further reading around the subject:
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