NHS health care is always free (hospital treatment, a visit from a district nurse or a visit to a GP). NHS funded Care is care that is arranged and funded by the NHS free of charge outside of hospital. It is available for people who need ongoing health care and meet certain criteria. This is also known as ‘fully funded NHS care’.
NHS Continuing Care
This can be provided at the home, in a care home or hospice. If someone in a care home is eligible for NHS continuing healthcare, this will cover all care home fees, including cost of accommodation, personal care and healthcare. If NHS continuing healthcare is provided at home, it covers personal care and healthcare costs. It may also include support for carers.
To be eligible for NHS continuing healthcare, the person must be assessed as having a ‘primary health need’ and have a complex medical condition and ongoing care needs. Not everyone with a longterm condition or disability is eligible.
If your parent doesn’t qualify for NHS continuing healthcare, then their local authority will be responsible for their care assessment and providing services if they are deemed to be eligible under their own assessment schemes.
To complicate matters, if your parent doesn’t qualify for NHS continuing healthcare, but is assessed as having care or nursing needs, they can still receive some care from the NHS. For someone in their own home, this could be part of a joint package of care, with some services coming from the NHS and some from social services. If your parent moves into a nursing home, the NHS may contribute towards nursing care costs.
Primary care trusts must carry out an assessment for NHS continuing care if someone’s physical or mental health worsens significantly or when someone is discharged from hospital. You can also request an assessment for your relative, through the GP or the Clinical Commissioning Group.
There is an initial assessment, followed up by a full assessment. The latter will be undertaken by a multi-disciplinary team made up of health and social care professionals already involved in your relatives care. They will use a ‘decision support tool’ to decide if your parent is eligible for NHS continuing care which covers areas including mobility, nutrition, continence, breathing and skin.
For each of the issues a decision is made about the level of need – priority, severe, high, moderate or low. If your parent has at least one priority need, or severe needs in at least two areas, they should be able to receive NHS continuing healthcare.
The assessment should consider your parent’s and your own views and you should be given a copy of the completed decision support tool document with clear reasons for the decision. You can challenge a decision if you’re unsatisfied by it by contacting the Clinical Commissioning Group.
(If someone’s condition is deteriorating fast, they should be assessed under the NHS continuing care fast track pathway, to put in place a care package as soon as possible. Government guidance says that care should be put in place within 48 hours of someone being found eligible under the fast track pathway).
You can read about NHS Continuing healthcare on their website.
NHS Intermediate Care
Intermediate care is another form of NHS funded care which includes free temporary care at home for 6 weeks following a stay in hospital, or to enable the person being cared for to stay at home following an emergency breakdown in care services (for example, a caring partner has been taken in to hospital).
If your parent has been in hospital, the hospital social work team will arrange the care before the patient is discharged. If your parent is at home, contact their local social services department, and make sure you let them know that it is an emergency situation.
Registered Nursing Care Contribution
Registered Nursing Care contribution is a tax-free, non-means tested benefit paid by the NHS to cover nursing or medical care. It’s paid whether the care is self-financed or funded by the local authority or trust. To be eligible your parent must need nursing care and is in a care or residential home that provides nursing care.
It is paid directly to the care home to reimburse them for the nursing care that is being provided. If you are self-funding all your own care, then your payments will be reduced by the Nursing Care Contribution amount.
If you are part-funding your care fees and costs then you might also get a reduction through the Contribution. It should also be paid if the stay in the care home is temporary, and if the stay is for six weeks or less, then there is no need for a formal assessment. This is particularly useful for periods of respite care.
You can ask for an assessment for Nursing Care Contribution at the same time as the Local Authority undertakes a needs assessment; or you can contact them afterwards and asked for a separate assessment.
Other NHS services available in care homes include continence aids and specialist/support or services such as chiropody, physiotherapy, pressure relief mattresses and mobility or communications aids.
The NHS have a guide on funded nursing care which you can read about here.
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