Who will pay for your elderly relative’s care? This is a vexed question at the best of times and it causes untold stress and anxiety for families up and down the country. Many struggle for months, sometimes years, to get the care funding their family member is entitled to. So it is easy to believe that during this unprecedented coronavirus crisis, getting care funding will be nigh-on impossible. But I’m here to tell you: it ain’t necessarily so.
What is NHS Continuing Healthcare?
Those with a “primary health need” should have their care needs met by NHS funding. This is the little publicised system of NHS Continuing Healthcare. It applies to care at home or in a residential or nursing setting. The problem is the concept of a ‘primary health need’ is not straightforward; there is no legal definition. Instead it is based on an expert judgement of the complexity, unpredictability and severity of a person’s care needs. The Government has produced a National Framework to ensure this judgement is made in a standardised and fair way. Unfortunately, many professionals fail to follow the Framework adequately, leading to assessments that are flawed, unfair and sometimes plain nonsensical. They may ignore families’ input, disregard important medical evidence, or underplay care needs. We know from listening to clients week in week out just what a harrowing, exhausting and frustrating process it can be.
What is happening during the coronavirus crisis?
Individuals leaving hospital under the Coronavirus Act discharge provisions who “may be eligible” for CHC funding should receive fully funded care until they can be assessed for NHS Continuing Healthcare funding. However, your family member may need to start paying for their care once the emergency period is over – unless they qualify for NHS CHC or local authority funding. Under the emergency Coronavirus Act, your family member will no longer be entitled to a full assessment of eligibility for NHS CHC funding to pay for care during the period the Act is in force.
However, this doesn’t mean our most vulnerable citizens can just be left to fall through the cracks. What if a relative who is just-about-coping at home takes a turn for the worse, ramping up their care needs dramatically? Or what if they have been self-funding residential care but the money runs out? The emergency legislation does NOT change the fact that the State still has a duty to safeguard those who are at risk of harm or neglect.
The Coronavirus Act has not put a stop to the duty to meet care needs
Like any legislation, the emergency Coronavirus provisions are open to interpretation. Your incapacitated family member still has a right to life, safety and security. Virus or no virus, health and care professionals must still respond in whatever ways they can to deal with unmet needs. They must still find ways to assess those needs and put care in place. This may mean using digital technologies where necessary as an alternative to a face to face assessment. It may mean getting the views and input of family members by telephone rather than in the room.
With family visiting and face-to-face meetings severely curtailed, scrutiny of decision-making during Coronavirus is at an all-time low. That doesn’t mean we give up. It means we work harder than ever to question, challenge decisions and hold people to account.
No one should slip through the net
It is all too easy in the current climate of fast, fraught and flexible decision-making for vulnerable people to slip through the net. So if you feel you are up against a brick wall, or that your relative is being treated as a number on a chart rather than a much loved individual, get in touch. I will do what I do best: listen to your story with both compassion and professionalism, and give solid, practical guidance in plain, easily understood terms. For Just Caring Legal, it’s business as usual. So stay safe and please call if you need help – we are here to advise you.