What is NHS Continuing Healthcare?
This is care that is arranged and fully funded by the NHS. It covers personal care, health care, and care home fees including board and accommodation. It’s available to people who are assessed as having a ‘primary health need’ – you’ll need to have significant health and care needs and require ongoing care outside hospital.
If you’re eligible, your care will be free. Unlike with council funding, you won’t be financially assessed to see if you have to contribute towards the costs.
Who is eligible?
Your main need for care will have to be health-related. There’s no list of specific conditions or circumstances NHS Continuing Healthcare covers, so you’ll need to have an assessment to find out if you qualify. This will assess the nature, intensity, complexity and unpredictability of particular needs. The eligibility criteria are strict – only people with complex health and care needs can qualify.
The assessment will start with an initial screening which decides if you are eligible for a full assessment. The full assessment then works out whether you have a ‘primary health need’ – if you do you are eligible for NHS Continuing Healthcare.
Your care needs will be reviewed at least once a year to make sure you’re still getting the right care. If your condition changes, you may find you no longer qualify for NHS Continuing Healthcare.
When will I be assessed for NHS Continuing Healthcare?
Clinical Commissioning Groups (CCGs) should carry out an assessment for everyone in their area who appears to need this sort of care. This might happen when, for example, you’re about to be discharged from hospital, your care needs are being looked at as part of a care needs assessment, or your care needs are being reviewed while you’re in a nursing home. If you’re not given an assessment, but think you should have been, ask your GP, social worker or CCG to arrange one.
NHS-funded nursing care
If you can’t get NHS Continuing Healthcare, you may qualify for NHS-funded nursing care. This is available to people who have been assessed as needing care in a nursing home. If you’re eligible, you’ll get £165.56 a week (2019/20 rate) towards the nursing part of your care home fees. If you are a self-funder, this is normally paid direct to the nursing home. If the council pays for your care, the funding will go straight to them.
For more information on who is eligible for NHS Continuing Healthcare and how the assessment works, see the NHS website.