Did you know that if you have been discharged from hospital after 1st September 2020 you may be entitled to free NHS care?
When did the funding scheme start?
From 1st September 2020, the Government introduced a national emergency discharge fund to cover the cost of post-discharge recovery and support for new or additional/extended care needs following discharge from hospital.
This funding scheme is FREE to the individual for a time limited period to enable time for their recovery and support, rehabilitation and reablement and in order to make decisions about their longer-term social care and NHS Continuing Healthcare care needs.
It is felt that the assessment of their longer-term care needs and support are best done in a community setting away from an acute hospital setting.
Why does the funding scheme exist?
Due to COVID, the Government’s aim is to encourage patient discharge from an acute hospital setting as quickly as practically possible in order to free up beds to cope with the pandemic and to help people return to the quality of life they had prior to their most recent admission
How does the funding scheme work?
Pre-1st July 2021: By automatically providing interim free care funding for up to 6 weeks for people being discharged from hospital who need a new or enhanced package of care – almost on a ‘no- questions-asked basis’, until assessment as to their long-term eligibility for NHS Continuing Healthcare Funding (‘CHC’) can be determined. [CHC is “a package of ongoing care that is arranged and funded solely by the NHS where the individual has been assessed and found to have a ‘primary health need’ as set out in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care. Such care is provided to an individual aged 18 or over, to meet health and associated social care needs that have arisen as a result of disability, accident or illness.” CHC is free and not means-tested].
Nb. This emergency discharge funding doesn’t apply if you are discharged from hospital with an existing care package and you don’t require new or additional care, as you will return to your previous care funding arrangement.
Although the Government’s discharge funding scheme has been in place since 1st September 2020 up until only recently, 30th June 2021, the NHS had just 6 weeks to carry out an assessment of longer-term eligibility for CHC and inform you of that decision.
If that 6-week target couldn’t be met, then the Government’s discharge funding comes to an end and the NHS (and /or Local Authority) are obliged to assume responsibility and continue paying instead. The NHS’s responsibility continues until such time as they (ie the CCG) have carried out a formal assessment for CHC and the outcome notified to you. So, in theory it is quite possible for this funding to continue well beyond 6 weeks following discharge from hospital!
Under-resourced CCGs will therefore be penalised for ‘slow play’ and will need to dip into their own reserves once the 6-week period has elapsed to ensure that there is no gap in the care package being provided.
Where are we now post 1st July 2021?
The Government’s emergency discharge scheme still remains in place, however since 1st July 2021, the Government has reduced the period of discharge funding from 6 weeks to only 4 weeks. So, people discharged from hospital between 1 July and 30 September 2021 (inclusive) will have up to four weeks of free funded care to meet the cost of their new or enhanced packages of care.
This shorter period means CCGs will now have to react even quicker to carry out their CHC assessments and have less time to give their outcome decisions as to eligibility for CHC funding.
In default, the NHS (and /or Local Authority) will have to continue paying until the task is completed. This will put enormous strain on their already stretched resources. Inevitably there will be delays in CCGs arranging assessments due to high volumes of cases, backlogs and the recent ‘pingdemic’ – all adding pressure to get assessments completed within 4 weeks. A tall order for the NHS!
Given the subjective interpretation and application of the assessment CHC criteria set out in the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, we expect many mistakes will have been made along the way and will continue to be made. Inevitably some individuals entitled to CHC Funding will be wrongly rejected for their desperately needed CHC care package, whilst conversely, others who may be less entitled, might actually get it. Much, we suspect, will depend on the assessors’ training and time devoted to each assessment. There is also a concern as to whether a period of up to 4 weeks is sufficient to fully identify the ongoing needs of individuals requiring a new or enhanced package of care and whether this may lead to individuals being assessed too soon after hospital discharge.
The outcome of the CHC assessment is vital as it will determine who pays for ongoing care.
So, if your primary need in terms of care is a health need, then you may be eligible for CHC, and if successful, ALL your care will be paid in full by the NHS, FREE OF CHARGE, and that includes the cost of accommodation, too!
If eligible for CHC, the NHS (via your local CCG) will continue to pay for care (or pay jointly with the Local Authority – known as a Joint Package of Care).
However, if not eligible, you will be passed over to the Local Authority to carry out their own means-tested assessment pursuant to the Care Act 2014. If your assets and capital are above the LA threshold (currently £23,250) for Local Authority funding, then you will have to pay privately and self-fund your own care.
Important! Until these assessments have been completed and you have been told the outcome, you shouldn’t be asked to pay a penny for your care!
Note: If you have been paying for care since 1st September 2020 whilst waiting an CHC assessment and have since been found eligible, you are entitled to a refund.
The Government’s discharge scheme is set to continue until 30th September 2021 but it is not known at present whether it will continue after this date.
For more reading look at the Government’s Hospital Discharge and Community Support: Policy and Operating Model published on 5th July 2021.
For more information around the subject, read these blogs:
COVID: How Will Backlogs Impact on NHS Continuing Healthcare Funding?
Things You Need To Check Before Your Relative Is Discharged From Hospital
Tell us of your experiences whilst accessing emergency discharge funding and if you’ve had to wait more than 6 weeks (now 4 weeks) and what happened, below..
If you need help with your assessment, get professional support and visit our 1-2-1 Support page.
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My dad was discharged from hospital to a home on the opposite side of the borough (25 mile round trip). We objected due to the distance & then told by SW if we don’t accept it, they’ll put him in under Section 21 anyway. We reluctantly accepted believing it’s only for the 6 weeks he’s being assessed & if it’s decided he needs to remain in a care home, we can look closer to home. At no point in those 6 weeks was dad assessed. I asked the care home manager as the 6 weeks were about to expire & she said it often takes longer than 6 weeks & she has other residents in the same position. I was contacted by SW to start assessment 1 day before 6 weeks expired but this was cancelled due to SW getting covid. 1st meeting with SW was on week 7. I asked about the financial status as the 6 weeks had expired & no assessment had taken place, which wasn’t dad’s fault. SW said they would continue to class his care as temporary. That same week, the LA also confirmed to the care home head office, they’d continue to pay. 1 month later, I got call from SW saying she’d filled out wrong paperwork & dad has to pay as the 6 weeks had now expired & he’s classed as self funding from mid October. We hadn’t even been informed of the fees that had since mounted up & was dissatisfied with the care in the home & wasn’t planning on keeping him there due to safeguarding issues. I’ve just written a complaint to the LA & copied in our MP. Why should dad pay for their delays & incompetence. They’re still assessing him. SW says we can’t take him home until assessment completed & care package agreed, yet he’s stuck in this home, where he’s essentially paying for his assessment. I’ve advised the home that the fees are in dispute.
We’re currently looking to move mum to a more suitable care home due to increasing needs. Whilst being shown around a home yesterday we brought up the fact we were trying to obtain CHC and the home manager told us that they wouldn’t be able to accept mum on CHC as the amount paid does not cover the homes fees and are not allowed to be topped up. Is this correct? Is there a cap on the amount paid to the home?