NHS Continuing Healthcare funding

Has the NHS capped your relative’s NHS Continuing Healthcare funding? Has their care home said they must pay a “top-up” to pay for “lifestyle” or “hospitality” facilities? If so, your vulnerable family member may have been the victim of illegal top-up fees for NHS Continuing Healthcare and even, in the worst cases, criminal financial abuse. In this case, they could receive a refund amounting to thousands of pounds.

Illegal top-up fees for NHS CHC are often dressed up in the language of “lifestyle choice”

We are fighting for a number of clients who were wrongly told they must sign a “lifestyle agreement” as part of their care home contract. In many cases, this was after their Integrated Care Board refused to pay sufficient  NHS CHC funds to cover the cost of meeting their care needs.

Such “agreements” are often dressed up in the language of lifestyle “choice”. They may refer to optional facilities at the home, such as cafes, gyms, or even a telephone. Homes will often ask residents to sign such agreements even if they are too disabled to access the extra facilities. Most of those in receipt of NHS CHC funding are incapacitated and/or highly immobile.

As one client whose father’s NHS CHC funding was capped told us: “We were asked to pay a top-up for “hospitality services” even though my Dad is bed-bound. He is in pain a lot of the time and completely immobile: he needs a hoist and two carers just to reposition him in bed. He spends his day watching TV or listening to the radio, both of which we provided for him. I find it really hard to figure out where these “hospitality” services come in.”

The practice of charging vulnerable residents often amounts to financial abuse

Even more concerning is that, unlike local authority top-up payments, which are paid by family members, many NHS CHC illegal “top-ups” are charged to the residents themselves.  Many are vulnerable, often with cognitive or communication impairments. Such a practice will often amount to financial abuse.

We have even heard of homes where some residents are receiving full funding while others are having to pay top-ups. Some care homes have served notices to quit if residents refuse to pay these so-called lifestyle agreements.

If someone is eligible for NHS CHC, their funding must cover ALL their assessed care needs

Let us be quite clear. Topping up NHS CHC funding to pay for essential care is illegal. It goes against the NHS’ founding principles. Under the legislation, NHS care is free at the point of use and must be adequate to cover ALL assessed care needs. All Integrated Care Boards have a statutory duty to follow this framework. They must pay the market rate for care, rather than placing arbitrary caps on how much they will contribute.

Has your vulnerable relative been financially preyed upon in this way? If so, any top-up payments may well have been illegal. Call or email us today. With our expertise in this area, we can maximise your chances of getting this hard-earned money back.