Are you receiving Continuing Healthcare – but still paying for social care?
This is a question families frequently ask on our blog and on our Facebook page.
So who does pays for social care when you receive NHS Continuing Healthcare? Let’s suppose your relative has an assessment for NHS Continuing Healthcare funding, and the outcome is positive and she is found eligible for that funding.
That’s good news from a funding point of view.
However, you may then be told that NHS Continuing Healthcare covers only health needs, and she will still need to pay for her social care.
Is this correct?
In a word: no!
The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care (the national guidelines) make it very clear:
National Framework pages 14-15, paragraph 33:
“Where a person has been assessed to have a ‘primary health need’, they are eligible for NHS continuing healthcare…… Where an individual has a primary health need and is therefore eligible for NHS continuing healthcare, the NHS is responsible for providing ALL of that individual’s assessed health AND SOCIAL CARE needs – including accommodation, if that is part of the overall need.”
So the NHS is responsible for ALL care fees – and if your relative is in a care home, it covers the cost of that too. Your relative should not be charged for any so-called ‘hotel costs’.
If anyone does tell you that the CCG will pay for your relative’s healthcare needs but their social care needs will be means tested, you can point them to the National Framework reference above.
There are occasions where ‘joint funding’ will be recommended. This is where the cost of care is split between the NHS and the local authority. However, the local authority will of course means test its part of the package. The first question to ask if you’re told that the assessment outcome is ‘joint funding’ is simply to ask why. If your relative has sufficient health needs to warrant at least some degree of NHS funding, then insist on a full rationale as to why they are not receiving full NHS Continuing Healthcare funding.
So, always keep in mind that the only time anyone should be means tested for care funding is:
- If you need care and you’ve been through the NHS Continuing Healthcare assessment process and you are genuinely not eligible for this funding, your care needs will become the responsibility of the local authority. This means your care is means tested.
- However, even if you don’t receive NHS Continuing Healthcare, you still don’t have to agree to a means test; you can simply start paying care fees.
- If you are told you need to be means tested before the NHS Continuing Healthcare assessment process has been carried out, insist on the Continuing Healthcare assessment first.
- No one should be asking you anything about your money or property until this has been done.
- It does’t matter how much money you have; it doesn’t matter whether or not you own a house; no one should ask you anything about this until the outcome of the NHS Continuing Healthcare assessment has been decided.
- If anyone tells you otherwise, refer them to our article: Why I shout at the radio.