What is NHS Continuing Healthcare?
NHS Continuing Healthcare is when the NHS are responsible for meeting the full cost of an individual's care home fees due to their primary need for care being a health need. The care is arranged and funded by the NHS and can be provided in a care home, hospital or in the individual's home.
What is a 'health need'?
In order for an individual to be assessed as having a primary health need, the nursing or other health services that the individual requires must be such that they are either more than incidental or ancillary to accommodation that the local authority is under a duty to provide or not of a nature that the local authority has the power to provide. Put simply, the level of care required is more than the limits of a local authority's responsibilities.
How do I make a claim for NHS Continuing Healthcare if I believe I am entitled?
Every individual requiring long term care due to age, illness or disability should be assessed by their Primary Care Trust or Health Board. Where the need for long term care has arisen through a stay in hospital, a qualified healthcare professional or social worker should complete the NHS Continuing Healthcare checklist before the individual is discharged.
What if an assessment is made and I disagree with the decision?
Each primary Care Trust and Health Board has an appeal process and this should be followed. It is likely to involve you attending a review panel.
What if I have been paying my care fees in full but I believe I should have been entitled to NHS Continuing Healthcare?
If you have been contributing towards care home fees since April 2004, you may be entitled to a reimbursement of your fees together with interest. This is the case even if an individual has since passed away; a claim can be made by their personal representatives.
What is the deadline for making a claim?
Any claim which relates to care provided between 1 April 2004 and 31 March 2011 needs to be submitted by 30 September 2012 – so you do not have long!