NHS Ongoing Healthcare Funding

If you are living with a complex health condition that significantly affects your daily life, you may be eligible for NHS Continuing Healthcare Funding (CHC). This funding is fully managed and funded by the NHS and is not contingent on your financial situation. However, the eligibility criteria for CHC are quite stringent. At UK Health Care Support, we assist families nationwide in gaining a better understanding of how they can finance their care, whether through available public funding or various financing options that can help cover the overall cost. If you have complex healthcare needs that necessitate nurse-led care and prefer to receive this care in the comfort of your own home, you may qualify for NHS Continuing Healthcare to support the funding of your care. In this guide, we provide essential information about accessing NHS Continuing Healthcare to assist with your care expenses.

What Does NHS Continuing Healthcare Funding Entail?

If you have a recognized primary healthcare requirement, care is provided free of charge in the UK through NHS Continuing Healthcare (CHC) funding. This form of care is organized and funded by your local Clinical Commissioning Group (CCG), offering you the flexibility to receive care either in a primary or acute healthcare setting or in the comfort of your own home.

Your CCG will conduct a thorough assessment of your needs to determine your eligibility for healthcare funding. To qualify for CHC funding, the assessment must establish that your needs are primarily healthcare-related, rather than solely social care needs.

UK Health Care Support has established robust partnerships with numerous CCGs, driven by our shared commitment to securing the appropriate funded care packages for our clients. This collaborative approach ensures that individuals receive the right care when needed throughout their lives.

We work closely with our clients and their families throughout the process, involving everyone in the development of the support plan. This ensures individuals can maintain their independence and well-being at home while providing comprehensive support to their families.

Comprehending the Checklist for NHS Continuing Healthcare

The NHS Continuing Healthcare Checklist serves as an initial screening tool employed by the NHS to identify individuals who should undergo a comprehensive assessment to determine their eligibility for NHS Continuing Healthcare funding. It represents the initial step in the evaluation process to establish whether you qualify for healthcare funding.

The NHS Continuing Healthcare Checklist comprises 11 assessment points that examine your care needs across various ‘domains,’ which are distinct aspects of your life where you may require additional support, such as nutrition or mobility.

The process is typically swift, and the threshold for advancing to the subsequent assessment stage is set at a relatively low level. If you require any form of supplementary care or support, it is likely that you will proceed to the full assessment.

How Can I Determine My Eligibility for Healthcare Funding?

Determining your eligibility for NHS Continuing Healthcare funding can be a comprehensive process, and the eligibility criteria are rigorous, which can be challenging for some families. Fortunately, our strong partnerships with local Clinical Commissioning Group (CCG) teams enable us to work efficiently to achieve the best possible outcome for our clients.

Here is a step-by-step guide to the complete application process:

  1. Requesting a Screening: Begin by requesting a continuing care assessment from your social worker or GP.
  2. Initial Screening: A medical professional assigned to your case will arrange an initial screening, known as ‘The NHS Continuing Healthcare Checklist,’ which can be conducted at your home or in a hospital.
  3. The Full Assessment: During this assessment, each of your healthcare needs will be categorized as low, moderate, high, severe, or priority. Eligibility for support is determined if you have one priority need and more than one severe need. The assessment considers various aspects, including breathing, nutrition, continence, skin integrity, mobility, communication, psychological and emotional needs, cognition, behavior, medication and drug therapies, altered state of consciousness, and other significant care requirements.
  4. Receive Your Decision: Your assessment results will be provided through your CCG, which will then make the final decision regarding the level of funding you will receive. They will communicate their decision and explain the basis for it.
  5. Appeal the Decision: If you are deemed ineligible, you have the option to appeal this decision. The first step involves writing an appeal letter to your local CCG. It’s also advisable to explore other healthcare finance and funding options. The CCG must acknowledge your request within five days.
  6. Appeal Process: When appealing, ensure you include supporting evidence for your claim. The CCG has three months to review all provided information and determine the next course of action. If you are not found eligible upon reevaluation, you can escalate your appeal to NHS England for consideration by an Independent Review Panel.

NHS Supported Nursing Care

If you have nursing requirements that necessitate nurse-led care, the NHS will cover the weekly fee for nursing care delivered in your own home. Similar to applying for NHS Continuing Healthcare funding, you will undergo an assessment of your needs.

Initially, it’s advisable to explore the possibility of NHS Continuing Healthcare funding. If your application for this funding is declined, NHS Nursing Care funding is an alternative avenue to receive financial assistance toward your care expenses. Many families find this payment beneficial in alleviating the overall cost of care.

CLINICAL EXCELLENCE AT PRESTIGE NURSING & CARE

At UK Health Care Support, clinical excellence is the cornerstone of our ethos and service philosophy. Our commitment to top-tier care is reflected in our nurse-led home care service, which is vigilantly overseen and backed by our seasoned regional nursing teams.

Our regional nursing teams comprise qualified and registered nurses, certified by the Nursing and Midwifery Council (NMC). Each possesses expertise in distinct nursing specialisms such as general adult nursing, learning and disability nursing, mental health nursing, and children’s nursing. This wealth of specialization empowers them to orchestrate and deliver safe, effective complex care to our clients. The central focus remains on ensuring an optimal care experience for our clients and their families.

Our nurses work hand in hand with care co-ordinators, carers, clients, and families to pinpoint precise care needs and strategize the most fitting care provisions. Their expertise ensures our carers are equipped with the necessary skills to deliver top-notch nurse-led care. Additionally, our nurses offer ongoing advice and unwavering support to families, aiming to instill confidence and assurance in the services we offer

How Will My Healthcare Funding be Disbursed?

Personal Health Budgets

If you are an adult eligible for NHS Continuing Healthcare Funding or a child receiving Continuing Care or NHS Funded Nursing Care, you will have the option to receive your funding through a Personal Health Budget (PHB).

The primary aim of a PHB is to empower individuals living with long-term health conditions and disabilities to have control and choice in how their funding is used to meet their health and well-being needs, whether in their own residence or a residential or specialized care setting.

The funding is provided by your Clinical Commissioning Group (CCG) and, in some cases, may be jointly funded with your local authority, depending on your care package.

You have several options for managing your funding and care arrangements:

  1. Direct Payments:

    • You or your representative receive the funding directly, allowing you to procure and oversee the care, support, and services you require. While specific procedures and spending guidelines apply, this approach provides greater freedom and control to determine what suits you best. Documentation demonstrating how direct payments are used is typically required.
  2. Third-Party Personal Health Budget:

    • An independent organization, such as a legal representative, manages the funding on your behalf. They organize and cover the costs of the care and support specified in your care plan.
  3. Notional Personal Health Budget:

    • Your NHS team administers the funding based on your assessed needs. They coordinate the care and support you require, including selecting the care provider and handling direct payments. In this scenario, you do not receive the funding directly.

If you manage your personal budget independently, you have the flexibility to choose your preferred care provider. If the CCG manages the budget, your choice may be limited to providers on their approved supplier list. However, it’s important to note that CCG or social services-approved suppliers have undergone rigorous safety and compliance checks.

What Healthcare Expenses Can Be Covered by NHS Continuing Healthcare?

If you are determined to be eligible for NHS Continuing Healthcare, you may no longer be eligible for certain other forms of funding and benefits. Here is a list of benefits that can be claimed in conjunction with NHS Continuing Healthcare, depending on whether you receive home care or reside in a care home:

Funding TypeHome CareCare Home
Local Authority Care FundingNoNo
NHS-Funded Nursing CareNoNo
Disability Living AllowanceYesNo
Attendance AllowanceYesNo
Pension CreditsAllSome
State PensionYesYes

Healthcare Funding Resources

If you require impartial information and advice regarding your home care funding options, numerous charities and advisory services can provide valuable guidance. These include:

  • Age UK
  • Independent Age
  • Money Advice Service

There is an organization known as ‘Care to Be Different,’ which offers practical advice on navigating NHS Continuing Healthcare funding. Care To Be Different was established by Angela Sherman, who had her own challenging experience securing healthcare funding for her parents. The website provides a wealth of tips and information on funding, funding assessments, and care fees

Reach out to our approachable care specialists for assistance with healthcare funding, or contact a branch near you. We offer unbiased guidance and advice to help you make the best decision for both you and your family.

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