The NHS Continuing Healthcare system is designed to provide free health and social care outside hospital for people with a primary health need. It is not means tested. However, it is getting harder and harder to get as NHS Integrated Care Boards (ICBs) pull the purse strings tighter. While it shouldn’t depend on an individual’s finances, we know it often does. In a recent letter to the Guardian newspaper, Janet Maitland from East Finchley wrote that when her relative had to go into a care home, “the first request for information was not about his health but his financial position. So they learned immediately that he had savings and owned his flat. From that moment on, in every meeting about CHC funding, where I spoke for him as he does not have the capacity to do so himself, it was clear that the money was the most important thing about him. In the end, I was defeated by people determined to minimise every medical problem he has.”
Which brings us back to a point we make often here at Just Caring Legal when our clients raise exactly this issue. Never agree to a financial assessment for care before your care needs have been fully assessed.
If you are eligible for NHS Continuing Healthcare, your finances are irrelevant
It is only after a care needs assessment that the financial assessment (or “means test”) might come into play. We say might, because if your care needs go beyond what a local authority can be expected to provide, then the NHS must meet them in full. This is NHS Continuing Healthcare. Like all NHS care, it is free at the point of use to anyone who needs it. If you qualify for it, your property, savings and assets are all irrelevant so there is no need for a financial assessment.
You do not have to agree to a financial assessment for care
Financial assessments must only happen with the consent of the subject, or their representatives where they lack capacity. So if you have not received a health and/or care needs assessment, you should not consent to a financial assessment. If you think you or your relative might qualify for NHS Continuing Healthcare, then insist on an eligibility assessment for this first. You can find out more about the two-stage eligibility process through our factsheets, such as this one on what constitutes a primary health need.
Don’t listen to those who tell you you “won’t qualify” for “free care”
We hear it again and again. People trying to arrange care for their relatives receive the message that they “won’t qualify for free care” because they own property or savings. Do not let this put you off pursuing a claim for NHS Continuing Healthcare. Whether you qualify depends only on the level of your care needs. The problem is, the eligibility process is highly complex and flawed, as Janet described in her letter. There is far too much room for subjectivity, leading some assessors to downplay or ignore important needs. It means that many people are ruled out for free NHS care when they do in fact meet the criteria. In this way, NHS England denies thousands of people a year the free NHS care to which they are entitled.
Do you think your relative may be one of those wrongly denied NHS Continuing Healthcare?
You may feel that your relative should qualify but that their needs have not been fully or fairly assessed. If so, feel free to get in touch. Here at Just Caring Legal, we specialise in maximising your chances of securing NHS Continuing Healthcare funding. We also appeal successfully against ineligibility decisions and obtain refunds of wrongly paid care fees, often running into six figures. Call or email today for a free initial assessment of your case. Because our help might just make the difference between hanging on to the house and spending most of your life savings on care. In the meantime, remember: keep your lips tightly shut about your finances until the whole NHS Continuing Healthcare process is fully concluded.
By Rosalind Hughes, founder, Just Caring Legal