Care Fees - Continuing Care Health Funding

Your local Clinical Commissioning Group is responsible for providing NHS continuing care health funding to people who are eligible and receiving care in the community or in a residential home.

Who is eligible for continuing care health funding?

Eligibility depends on whether the what is known as the “primary need” is essentially related to health. In short, if health care is more than a minor add-on to the social care and is therefore more than should be expected of social services, then the NHS should pay for the continuing care costs.

This is important because if NHS funding is not available, an individual will have to pay for their own care fees unless they qualify financially for social services support.

Care Fees Assessments

It has taken a number of years and decisions from the High Court, recommendations from the Parliamentary and Health Ombudsman and new Department of Health guidance to set up a new national framework for assessing whether people are eligible to have their care costs met by the NHS.

There has been a lot of media interest in the injustice caused to individuals who should have got NHS funding but in fact had to pay their own care home fees, often selling their homes to do so. Many people who have been paying care home fees are now seeking advice on whether they can recover those, sometimes after the patient has died. It can still be difficult, though, to get an assessment and to go through the review and appeal process.

Check out the Latest Deadlines for Claims

How we can help

Our Continuing Care Team specialise in this type of work and do it under a "no win no fee" arrangement wherever possible.

A benefit of a "no win no fee" agreement is that our fees should be covered by money paid back by the NHS.

Many organisations doing this type of work take a percentage cut of what is recovered and therefore do not take on cases worth less than tens of thousands. We charge for the amount of work done, if you win. We believe this is fairer. It can also help when the amount of fees paid is relatively modest, for example, where someone has died of a terminal condition after a short time in a home and has a strong case.

What you can expect from our continuing care team.

When first considering a case relating to continuing care we assess the strength and value of it and the likely level of costs and advise on whether we can offer a "no win no fee" agreement and on whether the claim seems financially viable.

Going into a care home?

Many people want advice before a move to a care home or very soon after and the continuing care case might then not be suitable for a no win no fee arrangement. We understand that sometimes it is important to protect future assets and can offer a fixed fee service for legal advice in cases like this.

Need information on getting an assessment?

General information on getting an assessment and how to appeal can be found, for example on the Age Concern website. They have produced a factsheet on NHS continuing care health funding and on other related issued like hospital discharge arrangements and financial assessments by the local authority social services department.

Public funding

There is a chance public funding might be available for NHS continuing care health funding cases if assets have fallen so low that someone is financially eligible for legal aid. Much of our work in other areas of community care law is publicly funded and we can discuss this possibility with you if you wish.

Protecting assets

There are other ways of covering the cost of care home fees, privately. Our parent company, Simpson Millar, have en expert in this field and you can find more information on how he can help you.

Contact us now to discuss how we can help you by completing our, no obligation, online enquiry form and we will call you back or you can call us directly on 0345 357 9850.

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Imogen Jolley - Education Law Solicitor | Simpson Millar| Lancaster

Imogen Jolley
Partner, Head of Education & Community Care

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