How to Get NHS Funding: What You Need to Know
07 December 2020
Did you know that you may be eligible to receive funding from the NHS that would cover every penny of your care costs? The NHS may pay for your care if you have long-term complex care needs, they may also pay for any home adaptations that you need.
Let us guide you through understanding what NHS Continuing Healthcare funding is, whether you are eligible for this money and how to get NHS CHC funding. We’ll also break down what a CHC funding checklist consists of and how continuing healthcare assessments work.
What is NHS Continuing Healthcare?
NHS Continuing Healthcare is a care package that is fully organised and funded by the NHS to support an adult’s long-term complex health needs. This could be due to a disability, illness or accident. CHC funding pays for the care a person over the age of 18 receives outside of hospital, in the form of at-home care or care in a residential home.
Who can get CHC funding?
To be eligible for NHS Continuing Healthcare funding someone needs to have a ‘primary health need’. This is when care is mainly needed to support or maintain a person's health, as opposed to helping them with any social or personal care needs.
Keep in mind that an adult’s eligibility and health needs are open to the interpretation of a professionally trained and experienced assessment team and a person’s diagnosis is not the factor that qualifies someone for NHS CHC funding. Therefore, it is not possible to know if someone will be able to get funding without an assessment and the needs of an individual can change, so a person’s eligibility for CHC funding can also change.
However, you have nothing to lose. If you get accepted then all of your care is paid for, and if you don’t then the NHS can help you get the support you need in other ways, such as through local authority funding.
It’s worth mentioning that the financial situation of a person will not be included in an NHS CHC assessment as Continuing Healthcare is not means-tested. So, there’s no need to worry about how much money you have. This is because the NHS have a duty to cover the care costs of a person’s long-term complex health needs.
Can someone with dementia get CHC funding?
As mentioned above, the criteria for receiving CHC funding is not based on what condition a person has. Therefore, some people with Dementia may be eligible for NHS Continuing Healthcare, but others may not be eligible. This is because CHC assessments and results are based solely on a person’s health needs, which can vary greatly person to person.
When should I be assessed for NHS funding?
In some situations, you will not need to apply for NHS funding, but instead a doctor or nurse will talk to you about your care needs. These situations include the following:
· If you are being discharged from hospital
· If your mental or physical health declines significantly
· If you are going into a residential care home
How do I get CHC funding?
If you think yourself, a friend, or a loved one is eligible for NHS Continuing Healthcare, ask a GP, social worker or healthcare professional for a Checklist assessment, and if you are in hospital, you can talk to your ward consultant. It is also possible to contact your Clinical Commissioning Group’s Continuing Healthcare department directly to ask for an assessment.
Sometimes, an assessment will be organised for you if you have been in hospital after an accident, fall or stroke, and need long-term care. An assessment should be set up for someone whose health deteriorates and needs care, but this does not always happen. In short, if you’re unsure about whether you are eligible for CHC funding, you should still ask for an assessment to find out.
All About the NHS Funding Assessments
There are two assessments for Continuing Healthcare funding. A CHC funding checklist assessment and a full CHC funding assessment. The checklist assessment decides whether someone needs a full assessment and the full assessment decides whether someone is eligible for NHS CHC funding. Let’s take a closer look at these assessments below.
Who carries out the Continuing Healthcare assessments?
A nurse, doctor or social worker can carry out a CHC funding checklist assessment. They must get your consent before doing this.
Clinical commissioning groups (CCGs) carry out both CHC funding checklist assessments and full assessments. CCGs are NHS organisations that arrange local healthcare services.
A multidisciplinary team (MDT) carry out a full CHC funding assessment. This team is made up of 2 healthcare professionals with different healthcare jobs. An MDT usually has representatives from health and social care who already help the candidate with their care. You will be told who the people are that are going to carry out the assessment.
What does the CHC funding checklist assessment involve?
The NHS Continuing Healthcare checklist is the first assessment carried out to decide if someone may be eligible for CHC funding. During an assessment a team will consider:
· The help a person needs
· The complexity of a person’s needs
· The intensity of a person’s needs
· The unpredictability of a person’s needs
· The possible risks if someone does not receive care
The team carrying out the CHC checklist assessment will write down why they think some is or is not eligible for funding, and you will be given a copy of this written assessment.
What is involved in a CHC funding full assessment?
The multidisciplinary team that carries out a person’s full assessment for NHS CHC funding will consider a person’s needs. These needs will be grouped under the following titles:
· Respiratory needs
· Nutritional needs
· Bathroom needs
· Skin-related needs, such as ulcers or wounds
· Mobility needs
· Communication needs
· Psychological and emotional needs
· Behavioral needs
· Medication and treatments
· Other important care needs
These titles and needs make up a Decision Support Tool. A DST is used by the team assessing an individual’s needs. In the assessment a person’s needs will be assessed as ‘priority’, ‘severe’, ‘high’, ‘moderate’, ‘low’, or ‘no needs’.
If someone has at least one priority need or two severe needs they will probably be eligible for NHS Continuing Healthcare funding. If someone has one severe need and other high or moderate needs, they may also be eligible for NHS CHC funding. The unpredictability, intensity and severity of needs are also taken into account.
A candidate’s views will be considered, and the views of their carers. The team will give you a copy of the written assessment with their reasons why you are or are not eligible for CHC funding.
How long does it take to find out the results of an NHS Continuing Healthcare assessment?
Someone should know the results of a CHC funding assessment 28 days after their assessment was requested, or their first assessment took place. This is the case unless someone’s care package is fast-tracked.
If the results take longer than 28 days and the reason for this is unjustifiable, you are entitled to a refund for any care costs from the 29th day onwards.
Can a CHC assessment be fast-tracked?
If someone urgently needs care their assessment may be fast-tracked. This could be the case if someone has a terminal illness or is nearing the end of life. Fast-track service usually takes around 48 hours.
When is CHC eligibility reviewed?
A person’s care and health needs can change, therefore their eligibility for NHS Continuing Healthcare can change. A person's needs and care package are reviewed after the first 3 months of receiving it, and then once a year after that.
What if I need help with an NHS CHC assessment?
The assessment period for Continuing Healthcare funding can be confusing and difficult. If you need support or advice you can visit the Beacon website or call their helpline – 0345 548 0300.
We hope that this information makes you feel more at ease about funding your care and encourages you to seek the support you need. If you are interested in hiring a carer, you can download the Curam app today.