By Rosalind Hughes, founder of Just Caring Legal
“Can my local CCG put a cap on NHS Continuing Healthcare even if this is not enough to meet the cost of care?”
In a way this question, which we are hearing more and more from clients, is a gift. Because unlike many others around NHS Continuing Healthcare, it has a very simple answer: no. No. NO! The NHS constitution could not be clearer: all essential care that the NHS provides must be free at the point of use. Therefore, there should never be an arbitrary cap on NHS Continuing Healthcare.
NHS Continuing Healthcare is personal health and social care arranged and funded by NHS Clinical Commissioning Groups. This is regardless of whether a person is in a residential or nursing facility or at home. NHS Continuing Healthcare must cover all the care requirements arising from a primary health need.
Unfortunately, it seems many local NHS groups are placing an arbitrary cap on NHS Continuing Healthcare. In some cases, this is at a level far below what it costs to purchase the necessary level of care in the local area.
Remember, this is care provided by the NHS – an institution that we pay into all our working lives. To have that care rationed at the very moment people need it most goes against everything the NHS stands for.
Because of the cap on NHS Continuing Healthcare, many care providers are charging illegal “top-ups”
NHS Continuing Healthcare funding is paid to very vulnerable people with a high level of care needs. This care does not come cheap. So many care providers make up any shortfall by asking care recipients and their families to “top up” NHS Continuing Healthcare out of their own hard-earned savings.
However, the National Framework on NHS Continuing Healthcare, which all CCGs are obliged to follow, is clear. Topping-up may be legally permissible under legislation governing Local Authority social care, but it is NOT permissible under NHS legislation.
That didn’t stop one of our clients being forced to “top up” their NHS Continuing Healthcare to the tune of £800 a week. Money they later got back thanks to our help.
If your CCG has put a cap on NHS Continuing Healthcare, we want to know!
Here at Just Caring Legal, we are building up a picture of which CCGs are persisting in this sort of practice. But we know there are more out there. So if you are facing a cap on NHS Continuing Healthcare, please get in touch. As specialists in care home fee restitution, we can advise you on your best course of action. And if you wish, we can talk to the CCG on your behalf.
If you are having to pay extra care fees to “top-up” NHS Continuing Healthcare, we can advise you on how best to challenge the care home too. Again, we can do as much or as little as you like. In many cases, this can include navigating you through the whole process of claiming a refund on wrongly charged care fees.
So get in touch today. Let us help ensure your relative is getting the NHS Continuing Healthcare they need in the way the NHS intended – for free.