How Much is CHC Funding and what are Top-up Fees?
If, following an assessment, you or your loved one are found to be eligible for NHS Continuing Healthcare Funding (CHC Funding), this will cover 100% of the care costs going forward. You shouldn’t have to pay a top-up fee unless you’re paying for some private services such as hairdressing. However, an increasing amount of Clinical Commissioning Groups do appear to be imposing ‘cost ceilings’ or a ‘limit’ on the amount of care fees that they are willing to pay.
Whilst having a guideline top figure isn’t unlawful, it shouldn’t be a blanket approach and each individual’s needs must be still covered in full, even if this goes over their guideline figure.
For a no obligation discussion about eligibility for CHC Funding, claiming back care fees already paid, or an issue with the NHS Continuing Healthcare Funding process, please get in touch with our Care Home Fees Solicitors.
The Clinical Commissioning Group can decide if there is an alternative care home or care provider that is cheaper. If the care services are like for like, they can insist that you use that particular care home/provider.
If your loved one is already settled in a nursing or care home which is more expensive than the alternative home the Clinical Commissioning Group is recommending and you refuse to accept the option it has put forward, then top-up fees may become payable – i.e. the difference between the costs of the two care homes.
However, the Clinical Commissioning Group must consider any health issues that moving someone to a different care home may cause. The distance from the person’s family may also be considered and overall, it should ensure that the best interests of the patient are being considered and that service quality isn’t compromised.
There is no limit to the amount of CHC Funding you can receive or for how long. However, if someone’s care needs change, then the need for CHC Funding may change and be withdrawn. An CHC assessment will usually be carried out annually, but if care needs change they can be carried out earlier.
If you’re looking to claim back care home fees paid in the past, then our Care Home Solicitors can help you request that a Retrospective Review is carried out. If following the assessment it was considered that CHC Funding should have been awarded at the time, then the Clinical Commissioning Group will, subject to evidence being provided, reimburse all the care fees paid over the time where CHC Funding should have been awarded plus interest from that date. This can sometimes amount to significant sums of money and we have recovered a number of 6-figure payouts for our clients.
Who is Eligible for CHC Funding?
CHC Funding (NHS Continuing Healthcare Funding) is available to people who have intense, complex and/or unpredictable care needs. It isn’t simply awarded if you suffer from a certain illness such as dementia, as each person is assessed individually on what needs they have on a daily basis to see if they’re over and above what the Local Authority can legally provide.
CHC Funding is available to people in any setting from your own home to a care home.
For a discussion with no obligation call our Care Home Solicitors
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