The NHS has Removed Continuing Healthcare Funding From me or Someone I Know: What can I do?

Author:
Hannah Morris
Care Home Fees Associate Lawyer
Date:
21/03/2022

Terminally ill people, patients whose health is deteriorating rapidly or anyone who has complex, intense or unpredictable health needs that they can’t manage independently, can be awarded Continuing Healthcare funding from the NHS.

It is important for families to note that NHS Continuing Healthcare funding is not only available to those at end of life or requiring palliative care. It can apply to anyone receiving care who is deemed to have a Primary Health Need; where their care needs are assessed to be intense, complex or unpredictable.” - Hannah Morris, Care Home Fees Associate Lawyer

NHS Continuing Healthcare funding, awarded under the Fast Track process, pays for the care and accommodation costs for:

  • people whose health is deteriorating quickly;
  • people who are in a terminal phase of their life.

Under the normal assessment process, the funding can also be awarded to those people who have ongoing complex, intense, and unpredictable health or care needs.

Over the last three years, 9,037 of people awarded fast track funding have had their needs re-assessed by the Clinical Commissioning Group (CCG), and around 62% of these patients have had their funding removed.

There are situations where fast track funding can be legitimately withdrawn, but the percentage seems overly high.” – Hannah Morris, Care Home Fees Associate Lawyer

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Why is the NHS Removing Continuing Healthcare Funding for so Many Patients?

When a patient is given fast-track Continuing Healthcare funding from the NHS, they can be assessed by only one medical professional who identifies they have an unstable or rapidly deteriorating condition and/or are approaching end of life.

Patients who are receiving fast-track Continuing Healthcare funding, but who live longer than expected, are being re-assessed by the CCG and a multi-disciplinary team, which includes both health and social care professionals.

Whilst their condition may have stabilised, this does not mean they are not left with ongoing complex, intense or unpredictable needs, which should mean the NHS continues the funding.

However, it’s believed that, during these assessments, assessors are downplaying patients’ ongoing health needs and are re-categorising them as social care needs instead.

In some cases (62% of cases to be exact) this then leads to complete withdrawal of their Continuing Healthcare funding, and they’re referred to the social care system instead where their ability to pay for their own care is means tested.

To receive NHS Continuing Healthcare funding – which covers the cost of an individual’s care in its entirety – the need for funding must be established primarily as a healthcare NOT a social care need.” – Continuing Health Care

Why is This Happening?

The cost of care is expensive. In 2019-2020 the average annual cost of a residential care home place was £35,000, increasing to £50,000 for a nursing bed. Many industry experts believe that the government is, therefore, seeing these assessments as opportunities to remove funding from as many people as possible, to reduce costs.

Even if that funding should legitimately remain in place.

What to do if you or Someone you Know has had Their Continuing Healthcare Funding Removed

If you or someone you know has had their Continuing Healthcare funding removed because they were deemed ineligible, we can help you.

“Simpson Millar has specialists that are able to give families advice about potential eligibility or ineligibly decisions. We can also assist families with applications for NHS funding as well as appeals of decisions recently made.” – Hannah Morris, Care Home Fees Associate Lawyer

If someone requires care primarily due to healthcare needs, it’s the NHS’s responsibility to fund that care. If they’ve removed this funding from someone you think is entitled to it, please get in touch with our team of Care Home Fees Solicitors for a free, no-obligation consultation.

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