Continuing Healthcare Funding issues - why isn't it simple to apply? (2023)

Continuing Healthcare Funding issues - why isn't it simple to apply? (1)

NHS Continuing Healthcare Funding issues.

Jane recently posted a comment which we wanted to share with you. She writes:

“I applied for CHC for my dad who, through my hard work and determination returned him home after a short but disastrous 6 weeks 21/2 years ago in a very highly rated home! He has Alzheimer’s, can be very aggressive and now needs to be fed, is doubly incontinent, we have the best Carer (private) as the system failed us massively in providing care! My mum also suffered from dementia! I applied for CHC for them both in December 2019 and Jan 2020 respectively! My mum’s health was failing fast! She died on 6th April – she had to be fed, had an ungradable sore (acquired in hospital) and was on oxygen and was doubly incontinent requiring regular manual evac [evacuation]! I watched my mum decline rapidly and yet neither were accepted for CHC! I’m not sure how dead a person needs to be to qualify but now I’ve experienced rebuttals and closing rank after appealing! I know it’s wrong but I am also tired of fighting and worry for my dad’s future that has been threatened by his GP in a veiled way. I’m beginning to wish I had never applied [as] mum suffered immeasurably because of my application and appeal, I firmly believe that, there is no other reason for her disgraceful treatment from DNS and GP – I’m saddened and disgusted ? my last communication said that no appeals would be accepted due to Covid 19! What kind of messed up system is this? They have paid for every ounce of their care and are by no means well off! Social workers don’t seem to want to know, they all sing from the same hymn sheet in this area it seems.”

Thank you, Jane, for sharing your personal comments with us about your dear parents and the struggles you have faced.

Your comments raise a number of interesting issues which may be helpful to our readers who are at different stages of their journey, whilst seeking eligibility for NHS Continuing Healthcare Funding (CHC) for a spouse, parent or relative:

1. Lack of Consistency:

Over the years, many readers have commented on our Care To Be Different website, that applying for CHC Funding is both complex and frustrating, and the outcome is unpredictable. There is often is a fine dividing line between those who get funding, and those who don’t. The assessment process is subjective and therefore prone to inconsistencies, flaws and errors. National surveys indicate that some parts of the country are more likely to award CHC Funding than others and has been referred to as ‘the postcode lottery.’ More needs to be done to make the whole process fairer, more transparent and consistent throughout the country.

Read our blogs:

When are the Government going to fix CHC?
Is the National Framework still working effectively?

2. New to CHC Funding?

Firstly, you need to understand the vital difference between healthcare vs social care needs.

  • Healthcare needs are provided by the NHS – free of charge – and include social care needs and accommodation. Healthcare needs are NOT means-tested – so your wealth should never be a consideration.
  • Social care needs are provided by the local authority (via Social Services) and ARE means-tested. So, if you have assets, savings or a home, you may have to pay for some or all of your care.

Unfortunately, many people who have not visited our website just don’t grasp this concept from the outset, and will embark on a lengthy CHC battle only to become frustrated when they eventually find out that their relative’s needs are clearly social care needs and simply don’t meet the eligibility criteria for CHC Funding; or else, unwittingly, get corralled down the route of social care assessments (and means-testing) and end up paying for care unnecessarily – when in fact they were CHC all along.

For more information about what constitutes healthcare needs and social care needs, read our blogs:

Part 1. Explaining The Vital Difference Between Social Needs vs Healthcare Needs
Part 2 – Explaining The Vital Difference Between Social Needs vs Healthcare Needs

3. Primary Health Needs

Eligibility for NHS Continuing Healthcare Funding is NOT about a particular condition or diagnosis, such as Alzheimer’s or dementia. It is about the complexity, intensity and unpredictable nature of those needs and the level and type of care that is needed to meet them. There are claims companies who may tell you that having a diagnosis, or a label for a particular condition is everything, but that isn’t the case. Eligibility for CHC is all about proving that your relative has a ‘Primary Health Need’. In simple terms, this means that they have complex, intense or unpredictable healthcare needs that are not incidental or ancillary to the accommodation your local authority is under a duty to provide and are not of a nature typically provided for by a Social Services. For more information about the Primary Health Needs approach, read our blog:

Apply for NHS Continuing Healthcare Funding if your relative has a ‘primary health need’…

4. The 12 Care Domains

Jane lists a number of medical issues that have affected her parents, including, Alzheimer’s, aggressive behaviour, incontinence (and manual evacuation), skin integrity (ungradable pressure sore), breathing problems (need for oxygen). These, and any other conditions, should all be assessed by the Clinical Commissioning Group’s (CCG) assessors at a Multi-Disciplinary Team (MDT) assessment and be recorded in the Decision Support Tool (DST). The DST comprises of 12 Care Domains, namely:

1. Breathing
2. Nutrition – Food and Drink
3. Continence
4. Skin integrity (including tissue viability)
5. Mobility
6. Communication
7. Psychological and emotional needs
8. Cognition
9. Behaviour
10. Drugs/Medication/Symptom control
11. Altered states of consciousness
12. Other.

Each Care Domain is ‘scored’ and the corresponding level of need is stated in the DST. The CCG’s assessors should look at your relative’s overall healthcare needs holistically and in conjunction with the 4 Key Indicators (Nature, Intensity, Complexity and Unpredictability) when reaching their decision as to whether your relative has a Primary Health Need and is eligible for CHC Funding.

For more reading around the subject, look at these blogs:

Has your relative been ‘made’ incontinent and developed a pressure sore?
PART 1 – Looking At The 4 Key Indicators: Unlocking the Basics
PART 2 – Looking At The 4 Key Indicators: Gathering pieces of evidence
PART 3 – Looking At The Four Key Indicators: Completing the Jigsaw
PART 4 – Looking At The Four Key Indicators: Drafting Your Conclusions

5. Closing Ranks

Sadly, Jane’s feelings are not uncommon. Many readers have previously told us how they feel let down by the whole CHC assessment process and believe that it is unnecessarily complex, unduly subjective and slanted in favour of the NHS.

Unfortunately, most GPs and medical practitioners who are not closely involved with the CHC process have little knowledge or understanding about it either, or the issues that affect families on a daily basis.

Social workers usually form part of the MDT assessment panel as a requirement under the National Framework for NHS Continuing Healthcare Funding 2018 (see paragraph 120). However, as with the CCG’s assessors, much depends on their training in the assessment process, understanding of the National Framework and their personal knowledge of the patient they are assessing. For some, it may be their first MDT assessment, and understandably, they may be taking their lead from the more experienced CCG appointed assessor (who may have an eye on budgeting).

6. How ill do you have to be to get CHC Funding?

Jane’s comments “how dead do you have to be…” are a typical reaction, echoing the sheer frustration expressed by many readers who cannot understand why their relative doesn’t qualify for CHC Funding – when their needs are clearly of a complex, intense or unpredictable nature that would justify funding! Remember, eligibility for CHC is all about healthcare needs. So, if you think your relative is eligible, you must pursue their right to a fair and robust assessment for funding and take it to appeal, if necessary. Read some other myths that people have been told about CHC Funding:

17 untruths about NHS Continuing Healthcare funding – Part 1
9 more untruths about NHS Continuing Healthcare – Part 2
The 10 Most Outrageous Excuses For Not Having An NHS Continuing Healthcare Assessment

7. Tired of fighting the NHS? Is the process wearing you down?

The CHC assessment and appeal process can be lengthy and tortuous. There are often long gaps waiting for the MDT and then for the outcome decision to be sent out, and then another lengthy wait for your appeal to reach Panel, followed again by a long wait for that outcome decision to be communicated to you. The process from start to finish should, theoretically, take months, but instead it is taking years! Many families lose patience and give up. Those that dig in for a fight can expect to wait years until a final outcome. In the meantime, they can be forgiven for feeling that they have been failed by a system that is supposed to support them yet leaves them angry and frustrated. You can, of course, get professional advocacy support at any and every stage of the assessment or appeal process, to help take strain off your shoulders. If you want help or wish to discuss a matter with a professional adviser, visit our one-to-one page. We applaud Jane, and all like her, who keep battling for CHC Funding. However difficult and time-consuming it may be, don’t give up! For inspiration, and an example that determination and perseverance pays off, read Admiral Mathias’ story:

‘Fighting for NHS funding for my mother was as complex as my work on the nuclear deterrent…’

For more reading around the subject, look at these blogs:

Part 1 – Revealing Insights From A Continuing Healthcare Nurse Advocate…
Part 2 – Revealing Insights From A Continuing Healthcare Nurse Advocate
Don’t Give Up When Faced With Ongoing Delays
Frustrated with CCG delays? Here’s how to complain

8. Dealing with Appeals

The appeal process can be daunting for families, even for seasoned veteran campaigners like Admiral Mathias. But to succeed, you have to persevere. We have written many helpful blogs on tackling the appeal process, depending on whether you are appealing an MDT decision to a CCG’s Local Resolution Panel or to an Independent Review Panel (IRP) conducted by NHS England. Of particular mention, is a very informative blog kindly prepared by a Chair of NHS England panel to help readers understand the appeal process and what goes on at the meeting:

Here’s some more reading on appeals which you will find useful:

Attending an Assessment or Independent Review Appeal?
Rejected for CHC Funding? Part 1: How To Appeal The MDT Decision
Rejected for CHC Funding? Part 2: How to appeal the Local Resolution Decision
Battling NHS delays – join the queue!

9. COVID-19

Unfortunately, COVID has caused immeasurable delays in both MDT assessments, CCG appeals to Local Resolution Panels and with appeals to NHS England. Most have been on hold for some time whilst the NHS understandably refocuses their attention to battling coronavirus and redeploys key staff to the front line to help with hospital patient discharge.

During lockdown, we hear that some CCGs have been conducting appeals by telephone, and similarly some IRPs have gone ahead, too – albeit in limited numbers.

We agree with Jane, that more needs to be done to process these outstanding appeal cases expeditiously. But, at present, it is difficult to foresee how long it will take to clear the huge backlog of existing assessments and appeals, never mind deal with the new ones currently waiting to fill up the pipeline.

Some positive news!

We have recently heard from one CCG “that under the Restoration and Recovery programme, the CHC team are hoping to recommence Local Resolution Panels towards the end of August 2020, assuming all critical personnel are back in their substantive posts, following re-deployment in response to the introduction of the Covid-19 procedures. It is expected that when panels recommence, they will be undertaken virtually via MS Teams, in recognition of the social distancing measures and therefore the limitations of face to face meetings. We anticipate undertaking cases in date order dependent on when rationales had been received. Any previously booked Local Resolution Panels that had to be cancelled at the start of the emergency response to Covid-19 will take priority.”

10. Interim Funding – Discharge from hospital and resuming healthcare assessments

Here is some more good news that we can share with you, taken from part of a recent letter from Sir Simon Stevens, Chief Executive of the NHS to CCGs.

“The Government have recently announced that it will continue to provide funding to support timely and appropriate discharge from hospital inpatient care in line with forthcoming updated Hospital Discharge Service Requirements. From 1 September 2020, hospitals and community health and social care partners should fully embed the discharge to assess process. New or extended health and care support will be funded for a period of up to six weeks, following discharge from hospital and during this period a comprehensive care and health assessment for any ongoing care needs, including determining funding eligibility, must now take place. The fund can also be used to provide short term urgent care support for those who would otherwise have been admitted to hospital.

The Government has further decided that CCGs must resume NHS Continuing Healthcare assessments from 1st September 2020 and work with local authorities using the trusted assessor model. Any patients discharged from hospital between the 19th March 2020 and 31st August 2020, whose discharge support package has been paid for by the NHS, will need to be assessed and moved to core NHS, social care or for self-funding arrangements.”

Here are some previous blogs concerning the impact of the COVID crisis on CHC Funding.

COVID: How Will Backlogs Impact on NHS Continuing Healthcare Funding?
COVID-19 – The Impact on NHS Continuing Healthcare Funding (‘CHC’) and How The Current Changes Will Affect You!

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FAQs

How long does it take to get CHC funding? ›

It should take no more than 28 days to complete the full assessment and make a decision.

What makes someone eligible for continuing healthcare? ›

To qualify for Continuing Healthcare funding, it must be proven that you have a 'primary health need'. This means that your care requirements are primarily for healthcare, rather than social or personal care needs. This is usually judged via a two-step assessment process; a Checklist followed by a Full Assessment.

What can CHC funding be used for? ›

The package of care is available to people who have significant long term healthcare needs, known as primary health needs and it covers all your care costs such as aiding with washing and dressing, medication provision, continence care, therapies and other complex health needs that would otherwise we carried out by a ...

What score do you need for CHC? ›

' A score of C shows that the individual is continent of urine and faeces, or that day-to-day continence care is simple and routine. Anyone with two or more A scores, or a total of five scores across A and B will be referred for a full assessment. This is a more detailed and lengthy process.

How many people get CHC? ›

The total number of people assessed for NHS CHC was 39,455 in Q3 2019/20. Of these, 14,602 were via the Standard NHS CHC assessment route and 24,853 were via the Fast Track assessment route. The total number of people assessed as eligible for NHS CHC was 28,369 in Q3 2019/20.

Who can complete CHC fast track? ›

Any clinician can complete a fast track assessment on behalf of the patient and submit the same to the Clinical Commissioning Group.

What triggers on a CHC checklist? ›

Completion of a CHC Checklist should be triggered automatically in certain circumstances, such as: when the individual is ready for discharge from hospital prior to a local authority funding assessment (NB. changes to hospital discharge due to COVID mean that Checklists are currently completed after discharge)

Can NHS continuing healthcare be backdated? ›

If they're then found eligible, with the delay being unjustifiable, funding should be backdated to day 29 after the CCG received the completed checklist. As delays can extend to many weeks or months, this backdating can result in a significant reimbursement of care fees paid for the interim.

What are the 12 domains for CHC? ›

The CHC assessment is divided into 12 care domains: • behaviour • cognition • psychological and emotional needs • communication • mobility • nutrition • continence • skin integrity (including wounds, ulcers, tissue viability) • breathing • drug therapies and medication: symptom control • altered states of consciousness ...

Is there a cap on CHC funding? ›

There is no limit to the amount of CHC Funding you can receive or for how long. However, if someone's care needs change, then the need for CHC Funding may change and be withdrawn. An CHC assessment will usually be carried out annually, but if care needs change they can be carried out earlier.

Does CHC funding affect benefits? ›

This form of NHS funding is used to pay for the personal nursing care of people living in either their own homes, or in a Residential Care or Nursing Home. Receiving continuing healthcare whilst still living in your own home does not affect any social security benefits that you may be able to claim.

How often is CHC funding reviewed? ›

If you're eligible for NHS continuing healthcare, your needs and support package will normally be reviewed within 3 months and thereafter at least annually. This review will consider whether your existing care and support package meets your assessed needs.

Can NHS funded nursing care be backdated? ›

If you, or a loved one, has paid the full cost of nursing care provision (i.e. nursing care has been self-funded), but you can demonstrate you or your loved meet the criteria for the FNC, then upon assessment it is perfectly reasonable to request that the Clinical Commissioning Group (CCG) backdates the FNC you should ...

What happens after CHC assessment? ›

Once your continuing healthcare (CHC) assessment has taken place, the NHS health and social care professionals involved with your care will recommend whether you are eligible for funded care. This recommendation is forwarded to the Integrated Care Board (ICB) responsible for funding in your area.

How do I get NHS funding for dementia? ›

If the person with dementia has complex health and care needs, they may be eligible for NHS continuing healthcare. This is free and is funded by their local integrated care board (ICB). A diagnosis of dementia doesn't necessarily mean the person will qualify for NHS continuing healthcare.

What is a CHC assessment? ›

The Continuing Healthcare assessment, sometimes known as a Full Assessment, is a detailed appraisal of your care needs – using a form called the Decision Support Tool (or DST) – to decide if you are eligible to receive NHS Continuing Healthcare (CHC).

Is NHS funded nursing care means tested? ›

FNC is not means tested, so your income and savings have no bearing on whether you can get it or not and it does not matter if you are a self-funder or if your local authority is paying for your care.

Does the NHS pay for end of life care? ›

Through the continuing healthcare program (NHS CHC), the NHS can help you pay for end-of-life care. The NHS CHC is not means-tested, so it doesn't depend on how much money you have. If you're eligible, the program pays for all your social care include care home fees and carers if you're still living in your own home.

How long does fast track CHC take? ›

This is done using the NHS Continuing Healthcare Fast Track process ('Fast Track Pathway Tool for NHS Continuing Healthcare'). Essentially, it's a fast assessment to get NHS funding in place as quickly as possible – usually within 48 hours of assessment.

Is dementia a primary health need? ›

Despite dementia being a medical condition, the needs of people with dementia are often seen as social care rather than healthcare needs.

How long does fast track CHC last? ›

Once approved, a care package should be in place within 28 days. People with a package of care funded by CHC are re- assessed after three months and then annually to review whether or not they still require support.

What is a positive checklist CHC? ›

A positive Checklist means that the individual requires a full assessment of eligibility for NHS Continuing Healthcare. It does not necessarily mean that the individual will be found eligible for NHS Continuing Healthcare (refer to paragraphs 104-107 of the National Framework).

Can you get continuing health care for dementia? ›

If you are living with dementia and have complex health and care needs, you may be eligible for NHS continuing healthcare. Being diagnosed with dementia does not automatically make you qualify as it depends on the severity and complexity of your health needs.

Who does a CHC checklist? ›

The CHC checklist is carried out by a qualified healthcare professional, such as a doctor, nurse or social worker. The checklist covers 11 core elements of care including continence, breathing, mobility, medication, emotional needs and cognition.

Is CHC and CCG the same? ›

NHS continuing healthcare (CHC) is a package of care provided outside of hospital. It is arranged and funded by Clinical Commissioning Groups (CCGs) for people aged 18 years and over who have significant ongoing healthcare needs and have been assessed as having a 'primary health need'.

What is a DST checklist? ›

Completion of a Decision Support Tool (DST) Upon completion of a positive checklist, a DST is then completed. A DST is an assessment tool used to investigate whether a person's needs are primarily healthcare needs that would be eligible for NHS continuing healthcare.

Do you have to pay care home fees after death? ›

If they pass away, their estate will be liable to pay for outstanding fees. When a person dies, the care home will issue an invoice for any outstanding fees. This is not for the family to pay, it will be taken from their estate, such as remaining money in their bank account.

What is a social services care package? ›

What is a social care package. A care package is a combination of services put together to meet a person's assessed needs as part of a care plan. The assessment or review is done by a social care professional. It says exactly what that person needs in the way of care, services or equipment to live their life.

What happens at a DST meeting? ›

The Decision Support Tool is usually referred to as the DST. The assessment will consider a range of possible needs, such as mobility, nutrition and behaviour. The person being assessed will be invited to take part and they may involve members of their family too, if they wish.

Can a DST be completed without a Checklist? ›

As a minimum, wherever an individual requires a care home placement or has significant support needs, a Checklist would be expected to be completed (unless the decision is made to go straight to the completion of a DST). 16.2 The Standing Rules state that the Checklist is the only screening tool that can be used.

What does the 86000 cap on social care mean? ›

The new charging policy framework

The cap will be set at £86,000 in October 2023. This will provide financial protection from unlimited care costs and, as a result, give people peace of mind from knowing that they will keep more of their assets when paying for their care.

How will new social care cap work? ›

The government have stated that the new social cap will be funded by both national insurance contributions and dividend tax rate increase. The national insurance increase of April 2022 will count towards the funding of the cap. Only those who are working above the state-pension age levy qualify to contribute.

What is NHS Continuing Healthcare easy read? ›

NHS continuing healthcare is an ongoing package of health and social care that is arranged and funded solely by the NHS where an individual is found to have a primary health need. Such care is provided to an individual aged 18 or over to meet needs that have arisen as a result of disability, accident or illness.

Does state pension stop if you go into a care home? ›

When you enter a care home (either temporarily or permanently) you can continue to receive the following benefits: State Pension. The mobility part of Disability Living Allowance or Personal Independence Payment. Incapacity Benefit / Employment Support Allowance Contribution Based.

Does CHC funding affect PIP? ›

If you will receive NHS CHC in a residential home, the care component of disability benefits is suspended after 28 days from time CCG funding begins but DLA or PIP mobility components continue. If you will live at home with an NHS CHC care package, you can continue to receive these disability benefits.

What does DS1500 form entitle you to? ›

The DS1500 sets out the patients condition, clinical findings, treatment, date of diagnosis and date of form completion. It is a medical factual report and it is usually valid for 3 years.

How do I appeal a CCG decision? ›

A. The first stage of appeal is through the CCG's local review process which may vary depending on where you live, but often involves a resolution meeting with the CCG continuing healthcare team. During the review process the CCG should try to resolve the matter informally without the need for further appeal stages.

What is the difference between care home and nursing home? ›

The main difference is that a nursing home always has a qualified nurse on-site to provide medical care. Both nursing homes and residential care homes provide care and support 24 hours a day, however, the main difference is that a nursing home is able to provide a higher level of care.

What is a package of care NHS? ›

NHS continuing healthcare is a package of care you may be entitled to receive if you have a serious disability or illness. It covers the full cost of your care (in your own home or a care home), including: healthcare. personal care, such as help getting washed and dressed.

Is CHC funding means tested? ›

NHS continuing healthcare (sometimes called NHS CHC) is a funding programme. If you're eligible, it pays for all your social care, including care home fees or carers if you're living in your own home. NHS continuing healthcare isn't means-tested, so it doesn't depend on how much money you have.

How much can you keep before paying for care UK? ›

You will not be entitled to help with the cost of care from your local council if: you have savings worth more than £23,250 – this is called the upper capital limit, or UCL, and will rise to £100,000 from October 2023. you own your own property (this only applies if you're moving into a care home)

Are next of kin responsible for care home fees? ›

Paying Fees After Death

When someone dies, their care home will issue an invoice for any outstanding care home fees. Next of kin will not have to pay this, but instead it will be taken from the person's estate.

What score do you need for CHC? ›

' A score of C shows that the individual is continent of urine and faeces, or that day-to-day continence care is simple and routine. Anyone with two or more A scores, or a total of five scores across A and B will be referred for a full assessment. This is a more detailed and lengthy process.

What qualifies you for CHC funding? ›

To get NHS continuing healthcare you must: have ongoing significant physical and/or mental health needs, and having taken account of all your needs, it can be said that the main aspects or majority part of the care you need is focused on addressing and/or preventing health needs.

How long does it take for CCG to approve funding? ›

As long as all the required information is submitted, it usually takes 30 working days from receiving an application to a decision, but it can often be sooner. Urgent cases can be processed more quickly if needed.

Do people with dementia qualify for CHC? ›

Some people with dementia qualify for NHS continuing healthcare (CHC) funding to meet the costs of some of their care needs, but the application process isn't always easy.

Do you have to pay council tax if you have dementia? ›

If you have a severe mental impairment of intelligence or social functioning which appears to be permanent, for example Alzheimer's or dementia, then you don't have to pay Council Tax. This is known as disregarded. The person must be certified by a doctor as severely mentally impaired and entitled to certain benefits.

How much will NHS pay for continuing care? ›

Not only does the framework for NHS Continuing Healthcare pay 100% of the fees associated with an assessed and established primary healthcare need, but there is also no financial limit of any kind and the National Framework explicitly prohibits patients paying 'top-up' fees.

Can CHC funding be backdated? ›

People who are eligible for continuing healthcare should have their funding backdated to the 29th day after the date on which the original referral was received.

Is there a cap on CHC funding? ›

There is no limit to the amount of CHC Funding you can receive or for how long. However, if someone's care needs change, then the need for CHC Funding may change and be withdrawn. An CHC assessment will usually be carried out annually, but if care needs change they can be carried out earlier.

What happens after CHC assessment? ›

Once your continuing healthcare (CHC) assessment has taken place, the NHS health and social care professionals involved with your care will recommend whether you are eligible for funded care. This recommendation is forwarded to the Integrated Care Board (ICB) responsible for funding in your area.

What triggers on a CHC checklist? ›

Completion of a CHC Checklist should be triggered automatically in certain circumstances, such as: when the individual is ready for discharge from hospital prior to a local authority funding assessment (NB. changes to hospital discharge due to COVID mean that Checklists are currently completed after discharge)

What are the 12 domains for CHC? ›

The CHC assessment is divided into 12 care domains: • behaviour • cognition • psychological and emotional needs • communication • mobility • nutrition • continence • skin integrity (including wounds, ulcers, tissue viability) • breathing • drug therapies and medication: symptom control • altered states of consciousness ...

Does CHC funding affect benefits? ›

This form of NHS funding is used to pay for the personal nursing care of people living in either their own homes, or in a Residential Care or Nursing Home. Receiving continuing healthcare whilst still living in your own home does not affect any social security benefits that you may be able to claim.

How often is CHC funding reviewed? ›

If you're eligible for NHS continuing healthcare, your needs and support package will normally be reviewed within 3 months and thereafter at least annually. This review will consider whether your existing care and support package meets your assessed needs.

What does the 86000 cap on social care mean? ›

The new charging policy framework

The cap will be set at £86,000 in October 2023. This will provide financial protection from unlimited care costs and, as a result, give people peace of mind from knowing that they will keep more of their assets when paying for their care.

Does the NHS pay for end of life care? ›

Through the continuing healthcare program (NHS CHC), the NHS can help you pay for end-of-life care. The NHS CHC is not means-tested, so it doesn't depend on how much money you have. If you're eligible, the program pays for all your social care include care home fees and carers if you're still living in your own home.

Can you get Continuing Healthcare for dementia? ›

If you are living with dementia and have complex health and care needs, you may be eligible for NHS continuing healthcare. Being diagnosed with dementia does not automatically make you qualify as it depends on the severity and complexity of your health needs.

How much can you keep before paying for care UK? ›

You will not be entitled to help with the cost of care from your local council if: you have savings worth more than £23,250 – this is called the upper capital limit, or UCL, and will rise to £100,000 from October 2023. you own your own property (this only applies if you're moving into a care home)

How long does fast track CHC take? ›

This is done using the NHS Continuing Healthcare Fast Track process ('Fast Track Pathway Tool for NHS Continuing Healthcare'). Essentially, it's a fast assessment to get NHS funding in place as quickly as possible – usually within 48 hours of assessment.

What happens at a CHC meeting? ›

This meeting will include you and the team who have worked with you on the assessment. The aim of the meeting will be to use the whole assessment to determine whether you have a 'primary health need' and are therefore eligible for a CHC package.

What is a positive checklist CHC? ›

A positive Checklist means that the individual requires a full assessment of eligibility for NHS Continuing Healthcare. It does not necessarily mean that the individual will be found eligible for NHS Continuing Healthcare (refer to paragraphs 104-107 of the National Framework).

Can NHS funded nursing care be backdated? ›

If you, or a loved one, has paid the full cost of nursing care provision (i.e. nursing care has been self-funded), but you can demonstrate you or your loved meet the criteria for the FNC, then upon assessment it is perfectly reasonable to request that the Clinical Commissioning Group (CCG) backdates the FNC you should ...

How do I get NHS funding for dementia? ›

If the person with dementia has complex health and care needs, they may be eligible for NHS continuing healthcare. This is free and is funded by their local integrated care board (ICB). A diagnosis of dementia doesn't necessarily mean the person will qualify for NHS continuing healthcare.

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