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NHS Continuing Healthcare funding: Vital support for people that need care

A recent article in the Sunday Times newspaper, published on the 15th of March, highlighted the case of Angela Woodward who has fought to claim back care costs for her mother, Florence, from NHS Continuing Healthcare.

The case highlights how difficult it can be to gain funding for people who are eligible for free care, including board and accommodation, provided that their main need is assessed as relating to their health.

The article also highlighted the fact that many individuals and families do not even realise that they are eligible for financial support, as information via health care professionals and local authorities appears to be very patchy.

The article also went on to highlight how NHS Continuing Healthcare funding can help families who are otherwise forced to sell their homes and exhaust their savings to meet the high cost of caring for their loved ones.

Funding apparently is not subject to a means test and there is no limit on the amount that can be paid – and importantly it is not age related. Many families however are finding it very difficult to secure funding and are often facing lengthy appeals in order to access support.

How does the scheme work?

The Sunday Times article goes on to explain:

NHS Continuing Healthcare is a free package of care for people who have significant on-going healthcare needs as a result of accident, disability or illness. It is arranged and funded by the NHS. If you qualify, it should meet the full cost of care including accommodation in a nursing home or hospice. Care can also be provided at home.

Funding is not subject to a means test. There is no limit on the amount, and it is not age related.

Who is eligible?

Generally, it applies to individuals with complex medical conditions that need additional care and support. To confuse matters, however, there is no clear-cut list of health conditions or illnesses that qualify, and assessment criteria is strict.

How do you apply?

Ask your GP or district nurse for an assessment that looks at care needs in a whole range of areas, from continence to mobility.

What is the process?

Anyone applying will go through an initial screening, after which the local health clinical commissioning group (CCG) will write to confirm whether there will be a full assessment. The assessment by several health and social-care professionals will consider all care needs in more detail, grading these by level of severity.

What happens if funding is refused?

You can ask the CCG to reconsider by appealing against the decision. As a final resort, you may turn to the Parliamentary Health and Ombudsman Service.

PHC HOME CARE COMMENT:

The Sunday Times article states that Angela Woodward’s mother was finally awarded just a month’s care costs under NHS Continuing Healthcare before she died at the age of 101, due to the lengthy and complex assessment process that applied to her case.

Angela Woodward took her case to the Strategic Health Authority. She argued that care should have been fully funded from when she first applied for continuing healthcare in January 2010. She eventually received payment — but dating back only to August 2010 and received no explanation why payment could not go back further as her mother’s condition was the same throughout that period.

People in similar situations should try to get assessed as soon as possible. It is important to fully understand how the process works and in particular the criteria that will be applied to an individual application.

NHS Continuing Healthcare is a valuable source of care funding that anyone eligible to receive should be pursuing with vigour.

Thank you to the Sunday Times for raising these issues.

For further information, visit: http://www.nhs.uk/chq/pages/2392.aspx?categoryid=68