A Flawed System: Continuing Healthcare Funding

Continuing Healthcare Funding, what a mind field this is, even the Governments own legislation is unclear to read with no clarity.  Is it any wonder so many professionals get it wrong leaving vulnerable people and their families struggling to pay for mounting bills?

This article doesn’t set out or intend to belittle the Continuing Healthcare Funding, but we will aim to offer some understanding and identify where professionals often make mistakes.

To understand Continuing Healthcare Funding, firstly we need to clarify what this means.  The NHS, states NHS continuing healthcare is the name given to a package of care that is arranged and funded solely by the NHS for individuals who are not in hospital and have been assessed as having a "primary health need".

If you are eligible, you can receive NHS continuing healthcare in a variety of settings, for example:

·         in your own home – the NHS will pay for healthcare, such as services from a community nurse or specialist therapist, and personal care, such as help with bathing, dressing and laundry

·         in a care home – as well as healthcare and personal care, the NHS will pay for your care home fees, including board and accommodation

NHS continuing healthcare is free, unlike social and community care services provided by local authorities. You may be charged for these depending on your income and savings.

The concept is to find out how a care plan helps patients take control of their condition by setting out goals that cater to their individual needs.

However, it isn’t as simple as that.  To be eligible for NHS continuing healthcare you must be over 18 and have substantial and ongoing care needs. You must have been assessed as having a "primary health need", which means that your main or primary need for care must relate to your health. 

Eligibility for NHS continuing healthcare does not depend on:

·         a specific health condition, illness or diagnosis

·         who provides the care, or

·         where the care is provided

If you have a disability or if you've been diagnosed with a long-term illness or condition, this doesn't necessarily mean that you'll be eligible for NHS continuing healthcare.  To find out whether you are eligible for NHS continuing healthcare, your care needs will be assessed.  NHS continuing healthcare will be reviewed regularly.  If your care needs change, the funding arrangements may also change.

To be eligible for NHS continuing healthcare, you must be assessed by a team of healthcare professionals (a "multi-disciplinary team") as having a "primary health need".  Whether someone has a primary health need is assessed by looking at all their care needs and relating them to:

·         what help is needed

·         how complex these needs are

·         how intense or severe these needs can be

·         how unpredictable they are, including any risks to the person's health if the right care isn't provided at the right time

Your eligibility for NHS continuing healthcare depends on your assessed needs, and not on any diagnosis or condition.  If your needs change then your eligibility for NHS continuing healthcare may change.

The whole process really sets up those involved and leaves them open to the worst possible kind of financial abuse of those who are vulnerable.  This isn’t just a care worker stealing thousands from your bank account or money from your purse, these are professionals who are carrying out assessments incorrectly and people being wrongly charged for their care.  It means many people have their entire personal assets illegally taken away from them to pay for care that the NHS should be funding in full.  The whole system is so flawed.