Have you considered NHS-Funded Nursing Care (FNC)?

Have you considered NHS-Funded Nursing Care (FNC)?

If your relative has already been assessed for NHS Continuing Healthcare Funding, but has been found ineligible, don’t give up! They may still be eligible for NHS-funded Nursing Care instead. Read on…

What is NHS Continuing Healthcare Funding? (otherwise known as ‘CHC’)

NHS Continuing Healthcare is a “package of ongoing care that is arranged and funded solely by the NHS where the individual has been found to have a ‘primary health need…Such care is provided to an individual aged 18 or over, to meet the health and associated social care needs that have arisen as a result of disability, accident or illness…..  Eligibility for NHS Continuing Healthcare is not determined by the setting in which the package of support can be offered or by the type of service delivery.”

This means that the free package of funded care provided by the NHS, can take place whether your relative lives in their own home, or in a care or nursing home.

CHC is not means-tested. It is simply a matter of health, not wealth.

The meaning of ‘primary health need’ and the assessment process for NHS Continuing Healthcare are both dealt with extensively in many of our other blogs which we encourage you to read, and  can be found on our website  www.caretobedifferent.co.uk.

If your relative has been successful in their application for NHS Continuing Healthcare, then all their clinically assessed health needs, including accommodation, will be met by the NHS in full.

But what happens if my relative doesn’t qualify for CHC?

If, however, the application for CHC is unsuccessful, then all is not necessarily lost!

An assessment of your relative’s daily nursing and care needs should then automatically be carried out by the Clinical Commissioning Group’s Healthcare Team, to see if they are entitled to NHS-funded Nursing Care (FNC).

Common mistake: Don’t get pushed into an assessment for NHS-funded Nursing Care before your relative has been assessed for NHS Continuing Healthcare. Otherwise, you may be paying care fees unnecessarily!

What is NHS-funded Nursing Care (FNC)?

If your relative has been rejected for NHS Continuing Healthcare Funding, but still needs nursing care, then they may be entitled to receive FNC.

FNC applies to individuals living in a care home who need some element of nursing care from a registered nurse.

FNC is not assessed, or means-tested and is tax free.

FNC is a weekly sum paid by the Clinical Commissioning Group directly to the care home, as a contribution towards the cost of your relative’s nursing care needs that are provided by a registered nurse, employed by the care home.

Nursing care includes, not only providing direct nursing care to your relative, but also tasks such as planning, supervising and monitoring their nursing needs.

Note: You cannot get FNC if your relative is either in their own home, in hospital, or a resident in a care home without nursing.

The current national FNC rate for England 2018/19 are £158.16 a week.

For self-funded residents (private paying):

If the care home is receiving a weekly FNC payment from the NHS as a contribution towards the nursing element of your relative’s care home fees, then that FNC payment should, in theory, reduce the weekly fees that your relative is liable to pay to the care home from their private funds. Simply put: if FNC increases, your relative’s contribution to their care home fees should reduce accordingly.

Any shortfall in the cost of nursing will be paid by your relative, unless there are any other contractual arrangements in place to cover the cost, such as contribution from or joint package of care with the Local Authority.

We always recommend that you check the contract to see what it says about FNC and whether the care home fees charged are inclusive or exclusive of FNC.

Once my relative has FNC, can it be withdrawn?

Yes.

FNC can be withdrawn if it is no longer appropriate. For example: (a) if your relative no longer lives in a care home; or (b) lives in a care home but does not now need any level of nursing care from a registered nurse; or (c) your relative’s healthcare needs have changed, and they have become entitled to fully funded free NHS Continuing Healthcare instead.

Summary

It is surprising to learn that so many people miss out on FNC if their relative is found ineligible for NHS Continuing Healthcare Funding.

Remember: The key point is that your relative should first be formally assessed for NHS Continuing Healthcare Funding, and only if that assessment fails, should they then automatically be considered for FNC. It should never be the other way round.

So, if your relative has first undergone an assessment for NHS Continuing Healthcare and been found ineligible for this free funding, then, as a default position, ensure that the NHS Continuing Healthcare Team undertakes an FNC assessment. Any NHS contribution will undoubtedly help defray the care home costs payable.

For further reading on the subject:

Read paragraphs 246 to 269 National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (revised October 2018).

5 Comments

  1. Lisa Morton 4 months ago

    My mother is (and has been since 2012) resident in the dementia unit of a care home. She has advanced dementia and is self-funded. The care home also has a separate nursing unit as well as a general residential unit located within the same building and whose residents share communal facilities.

    My sister and I have just finished a most laborious and stressful, unsuccessful claim for CHC for my mother’s care.
    Mum’s claim for CHC was declined as it was deemed she did not have the requisite primary health need and as also declined FNC even though she receives an element of nursing case (mainly provided by a trained senior carer).

    It states on the letter from the CCG that mum would be eligible for FNC if she was resident in the nursing unit (located upstairs in the same building and overseen by the same nursing staff). To move mum upstairs to the nursing unit purely to receive the FNC would be hugely detrimental to her, particularly with regard to her advanced dementia. I fail to understand how she is ineligible purely down to which room she occupies within the same building.

    Has anyone else suffered the same dilemma and how did you resolve it (if at all) .

    • Care to be Different 4 months ago

      Hi Lisa – so sorry to hear this. If you would like to speak to us about the possibility of appealing the decision not to award CHC then please do get in touch. The issue of which floor your Mum resides on is ridiculous. If she needs nursing care rather than residential care then it should not matter where the care is provided. Kind regards

    • AJ 2 months ago

      I am not an expert, just in a similar situation. But many homes have a residential unit downstairs and a ‘nursing unit’ upstairs/unit. The NHS funding would only kick in when she is officially in the nursing unit. Most homes, distinguish by having a higher fees for the nursing unit. Perhaps you need to have her reassesed and moved if you really want the funding. Annoying but unfortunately true 🙁

      • Care to be Different 2 months ago

        Hi AJ – Not necessarily true. CHC Funding eligibility is not dependent on the setting of the care. Funding can be provided whether you are in residential care, nursing care or even at home. Kind regards

  2. Lynda Ferrigan 8 months ago

    Where do I find rules that apply in Scotland?

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