Understanding who pays for care when someone is Sectioned is something that is actually quite straightforward. It’s important to be aware of some key points, though.
One of the most important things to be aware of is the connection between the Mental Health Act and NHS Continuing Healthcare funding…
Dementia, care funding and the Mental Health Act
Severe dementia often goes hand in hand with challenging behaviour. When someone needs full time care because of these needs, they should have an assessment for NHS Continuing Healthcare, and all their care needs should be taken into account. (NHS Continuing Healthcare is full funding for people who need full time care primarily for health needs.)
As a separate thing, if a person’s behaviour and/or mental health poses threat to themselves and/or to others, that person may also be ‘Sectioned’ under the Mental Health Act.
Being Sectioned means the person is effectively detained, either in hospital or in another kind of care facility (including a care home) for everyone’s safety.
The person will be detained under Section 3 of the Mental Health Act, and the care they need (known as aftercare) relates to Section 117 of the same Act. This care is often known as ‘Section 117 aftercare’.
So who pays for care when someone is Sectioned?
In a nutshell: Clinical Commissioning Groups (CCGs) and local authorities pay. The individual should not be charged.
However, there are several things to keep in mind…
- Under Section 117 CCGs/NHS and local authorities are obliged to provide free care until the Section is lifted.
- This free care relates to the needs arising from the actual mental disorder or cognitive impairment that led to the Section. It applies to people with or without dementia who have, for example, challenging behaviour or who are a risk to themselves.
- The person may have additional care needs that are not related to the Section – and these needs should be assessed separately, for example via the NHS Continuing Healthcare process, just as they would be if no Section were in place.
- The budget for Section 117 aftercare is not the same as an NHS Continuing Healthcare budget.
- Regardless of whether the 117 aftercare services are provided by the CCG or the local authority, this 117 care should never be means tested.
- There is no long funding assessment process for 117 aftercare services (unlike with NHS Continuing Healthcare where the process can be extremely drawn out). Instead, if a person is Sectioned, the relevant care is funded by the state – and that’s that.
- All other Continuing Healthcare rules remain the same, regardless of whether a Section is in place. Also, just because a person is in receipt of 117 aftercare does not mean NHS Continuing Healthcare funding can be ignored for additional needs.
- The availability of 117 aftercare services doesn’t mean that everyone with severe dementia and challenging behaviour will automatically receive free care. There needs to be a Section in place first, and this is a separate thing to Continuing Healthcare. However, the two can run in parallel.
- Even if a Section is lifted, the person still doesn’t necessarily have to pay for care just because they have savings. As in all cases, it depends on a person’s health needs first and foremost. The NHS’s duty to provide funding for nursing care – and its duty to assess all needs properly – still applies, and no Section should be lifted without proper re-evaluation beforehand.
If your relative is currently under a Section, and that Section is then lifted, be sure to check this has been done with full and proper review and reassessment. If you suspect the Section has been lifted to force your relative back into means testing, be sure to complain.
In addition, if you find that a Section has been conveniently lifted the day before an NHS Continuing Healthcare funding assessment, question this thoroughly.
Do you have personal experience of this issue?