Boris Johnson said in his Economy Briefing on 30th June 2020:
“We won’t wait to fix the problems of social care [which] every government has flunked for the last 30 years. We will end the injustice that some people have to sell their homes to finance the cost of their care whilst others don’t…”
For many years now, Care To Be Different has been helping individuals and their families through the tortuous NHS Continuing Healthcare Funding (CHC) process. CHC is not means-tested, is free at the point of need, and is delivered by the NHS to individuals with a ‘primary healthcare need’ ie who have intense, complex or unpredictable healthcare needs beyond which a local authority can lawfully provide. CHC is provided regardless of wealth or the setting where the care takes place – be it a care or nursing home, your own home, other care facility or a hospice.
CHC was originally provided by individual Strategic Health Authorities, each applying their own assessment criteria. This led to a great deal of subjectivity and inconsistency throughout the country as to who might receive CHC – free care from the NHS – and who would have to pay for it from their own funds (‘self-funders’). The nationwide disparity has been described as a ‘postcode lottery’, and depending on where you lived, could dictate whether you were more or less likely to be awarded CHC. This proved grossly unfair to those deserving of CHC, who were being denied funding by a flawed system. So, two individuals with similar needs may experience totally different outcomes. One may receive a CHC package and have all their healthcare and social needs paid for in full by the NHS; the other might be forced to pay for their care privately and end up selling their home.
That changed in 2007 with the introduction of the NHS National Framework. The intention was to create a uniform, fair and consistent assessment and appeal process throughout the country with clear nationwide guidelines. The National Framework has since evolved over the years with several revisions, recently culminating in the latest version – The National Framework for NHS Continuing Healthcare Funding and NHS-funded Nursing Care – which came into force on 1st October 2018. This latest edition is an improvement and addresses some of the previous omissions, but it is not yet the perfect article. The assessment process remains subjective and that means that there is still the opportunity for inconsistency and errors in its application and the outcome as to eligibility for CHC Funding. Many families feel that the process is slanted in favour of the NHS and it is not user-friendly.
The National Framework principally deals with the issues surrounding NHS CHC Funded care which also includes social care funding, so there is, of course, interaction with local authority funding, mention of joint packages of care (funded jointly by both the NHS and local authority) and now inclusion of the Care Act 2014 (which deals with social care funding issues and assessments).
If you are ineligible for CHC Funding, then you should pass over to the social services to see if you are eligible for alternative funding instead from the local authority. The difference is that local authority funding is means-tested, and so, depending the level of your assets and savings, you could well end up paying for your own care if you are over the threshold (£23,350).
For more information about what constitutes healthcare needs and social care needs, read our blogs:
Care provided in your own home or in a care home can be very expensive, often costing on average around £6,000 a month / £72,000 a year and upwards – depending on your locality and facilities offered by the care home. Care homes will demand regular payment as part of the contractual arrangement. If self-funding, care fees can mount up pretty quickly and the family assets – usually the home – is often sold to pay for a relative’s care.
The Prime Minister talks of boosting NHS funds and creating 40 more new hospitals, which is both welcome and much needed. He talks about improving social care and also not having to sell your home to pay for social care – also most welcome!
But, he does not specifically mention NHS Continuing Healthcare! At the heart of the National Framework (and supported by Section 9 of the Care Act 2014) is the core principle that eligibility for CHC should be considered before local authority funding or private funding are ever mentioned. The first discussion should always be about healthcare needs ie CHC, and not how you are going to pay for your care! Unfortunately, that is not always the case, and quite often, CHC is not even on the agenda.
Transparency: The PM doesn’t deal with the NHS’s past failings to openly tell the public about the availability of NHS Continuing Healthcare Funding, or of its failure to freely volunteer an initial assessment to at least ascertain whether an individual could be eligible for CHC.
The outcome of a successful CHC application should result in all your assessed healthcare needs being paid in full, by the NHS, free of charge. No need to sell your home; no need to contribute to your healthcare needs! You’ve saved all your life and paid taxes, so that at the point in your life when you most need care, you should be entitled to receive it free of charge.
Sadly, however, CHC rarely features on the public agenda. Unless you happen to come across it by chance, most families looking into care will never have even heard of it, and instead will be pushed down the route of self-funding care and most likely having to sell their home. CHC is has been described as the ‘NHS’s best kept secret’. Care To Be Different strives to promote CHC and offers families lots of free resources and information on its website to help you navigate the CHC system.
Whilst the NHS have excelled in coping with coronavirus, the Prime Minister has not yet addressed the misery that thousands of families have suffered as a result of inadequate and flawed NHS CHC assessments – where individuals justly deserving of free NHS care packages to meet their healthcare needs – have been turned down for CHC Funding and instead have been forced to sell their home to pay for their care. Remember: CHC is ‘free at the point of delivery’ (paragraph 180 of the National Framework). Nor has the PM yet sought to address the assessment and appeal’s process which still remains flawed and far too subjective, frequently leading to incorrect outcomes and decisions to reject or withdraw existing CHC Funding – which are fundamentally wrong – heaping distress and financial misery on families. As an example, read Admiral Mathias’ story:
We wonder how many thousands of homes have been sold needlessly over the years to pay for care, which should have been funded by the NHS? Had CHC been awarded, then this stressful and anxious situation could have been avoided. Read our blog: Is the National Framework still working effectively?
Hopefully, the Prime Minister will address these funding issues when the Government reviews social care funding.
Leave a comment below and let us know what you think the Government ought to be doing to promote the awareness and availability of CHC Funding…