Continuing Healthcare (NHS)
The question of when a person becomes eligible to have their health and social care needs fully funded by the NHS has been the subject of a number of court cases (eg R v North and East Devon Health Authority, ex p Coughlan and R (Grogan) v Bexley NHS Care Trust) and also various government guidance over the last 20 years or so. There is now specific guidance in England and Wales which, although very similar, is not absolutely identical.
In very broad terms, a person who has a ‘primary health need’ would be eligible for NHS Continuing Healthcare (NHS CHC). This refers to care that is provided by, and solely funded by the NHS in a hospital, hospice, care home or an individual’s home.
Eligibility for NHS CHC is decided by a multi-disciplinary team of professionals, including a doctor, social worker and district nurse, who follow a decision support tool to assess each individual who presents a potential primary health need. The NHS is the ultimate decision maker in such cases.
The financial advantage of CHC is clear as the required services are provided by the NHS for free, if you are eligible. Unlike care provided by the local authority, there is no means testing or contributory element.
NHS Funded Nursing Care is not the same as Continuing NHS Healthcare. NHS Funded Nursing Care refers to the nursing care element of a care package which is primarily funded by the local authority. The required element of nursing care will be provided for free by the NHS, but the remainder of the care package will be subject to means testing by the local authority.
Re-claiming Nursing Fees
If you have paid, or are paying, nursing care fees for yourself, or a relative, and have questions about whether you could qualify for free care under NHS CHC, please contact us now.