By Rosalind Hughes, founder of Just Caring Legal
Has a care provider asked you to pay NHS Continuing Healthcare top-ups?
Illegal NHS Continuing Healthcare top-ups are something we are seeing at Just Caring Legal on an increasingly regular basis. One common scenario is that the Clinical Commissioning Group (CCG), which funds NHS Continuing Healthcare, caps the amount of money it will pay out. In many cases, this is a lower figure than the cost to the home of meeting the person’s essential care needs. This practice is illegal in most of the UK *. NHS legislation says that all essential health and care needs should be met for free. NHS Continuing Healthcare must be sufficient to cover all care requirements that arise from a primary health need. Nevertheless, NHS Continuing Healthcare top-ups are happening widely.
NHS Continuing Healthcare top-ups are often presented as “lifestyle” extras
Many care homes try to square the circle by asking NHS Continuing Healthcare recipients to pay top-up fees. Often, the agreement requires an extra amount to cover “hospitality” or “lifestyle” extras, such as communal cafes, gym facilities, cinema rooms. You would be amazed how often we hear of residents entering such agreements even when they are completely immobile, or suffering from severe dementia. In other words, when they are clearly unable to take advantage of these extra facilities.
Many NHS Continuing Healthcare top-up agreements are unfair under consumer law
In most cases, as we have been stressing for a long time, NHS Continuing Healthcare top-ups are illegal. The Competition and Markets Authority has been investigating the practice too. Recently it forced one care home provider, Care UK, to pay back more than £1 million in refunds to NHS-funded residents. These residents had been paying “premium” rates at certain Care UK care homes. Some were paying more than £300 a week extra to receive care there. The CMA’s Executive Director of Enforcement Michael Grenfell said, “Older people receiving Continuing Healthcare funding are some of the most vulnerable in our society and should not be expected to pay extra fees towards their essential care.”
Each case is different so get in touch with your story
If you have signed a care home agreement requiring NHS Continuing Healthcare top-ups, we urge you to get in touch. Don’t be put off by the length of time that has elapsed since you signed. In one case, we won a refund for a client for care fees stretching back eight years.
As specialists in both care fee restitution and litigation, we will honestly weigh up your chances of success. If necessary we can also guide you through the complex processes involved. We guarantee to listen with compassion and professionalism and to give you plain, straightforward advice. Each story we hear is unique, but at the heart of every single one is a vulnerable person who simply deserved care, respect and fair play. So get in touch, and tell us your story today.
* In Scotland under Hospital Based Complex Clinical Care (previously known as NHS Continuing Healthcare) if someone has a health need the NHS is responsible for meeting that need free of charge. However, care homes can ask residents to contribute (subject to their financial circumstances) towards their social care and accommodation costs. Just Caring Legal only deal with cases in England.