10 untruths about Continuing Healthcare Funding


If you are told untruths about NHS Continuing Healthcare Funding or are subjected to flawed funding assessments and decisions, it can have devastating financial consequences for your family.

A negative outcome refusing or withdrawing CHC Funding can result in families paying many thousands of pounds each month for their relative’s care fees, quite unnecessarily. This may be from private savings or the sale of their home.

Misleading or incorrect statements about their entitlement to CHC, could put families off even seeking an assessment for eligibility or pursuing valid grounds for appeal.

Here are 10 typical untruths families are told about NHS Continuing Healthcare Funding. They’ll help you recognise and challenge false information you may be given.

  1. You are not entitled to see any of the assessment notes

If it’s you who is being assessed, then of course you’re entitled to see the assessment notes and the decision-making rationale for the CHC Funding decision.
Alternatively, if you are acting as your relative’s representative, you’re also entitled to see the notes and decision-making rationale. Without this, you’re being denied the ability to properly consider appealing any decision that denies funding. So, insist on being sent a copy.

Your position will be strengthened if your living relative has given their express consent or you are appointed as their Attorney under a valid Lasting Power of Attorney. Failing which, you can argue ‘best interests’.

2. You are not entitled to attend CHC assessment meetings

Many families are told this, and it’s not correct. Indeed, the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care makes it very clear that the assessment process is intended to be ‘person centric’ – in other words, the individual is at the heart of the assessment process.
What’s more, the National Framework says that families should be fully involved in the process and they should have the opportunity to participate and give their input.

3. You are not allowed to speak during assessment meetings

This is complete nonsense!
You have every right to be heard and to fight for your relative’s case on eligibility, and make all the verbal and written points you want to support their case.

The first 2 points we covered make it very clear how important it is that the person being assessed and/or their representative are fully informed, empowered and encouraged to play a central role, and contribute to the assessment and decision-making process. Make sure you familiarise yourself with the National Framework.

4. You are not allowed to take anyone with you to assessments

Again, this is rubbish!
You can take someone with you to support you, to be your advocate or just to provide a listening ear or take notes – even if you are already representing your relative.

You can take more than one person with you if you want to.

It’s courteous to let the NHS Assessors know who will be coming with you, but don’t let them convince you that you can’t bring anyone.
If you are denied access or an advocate, that will give grounds for appeal.

5. If you take a solicitor with you, the solicitor is not allowed to speak

Not true! See the National Framework.
In short, your solicitor or other legal advocate will have exactly the same rights and status as any other kind of non-legal representative to speak and ask questions about the CHC assessment process taking place.

Given that the assessment process can be a daunting, complex, and emotional experience as you battle with the NHS for your relative’s entitlement to CHC Funding, we recommend you consider seeking professional guidance and advocacy support.

6. Local Authorities never get involved in the NHS Continuing Healthcare process

Incorrect. Local authorities MUST be involved in the Continuing Healthcare process! How else will they comply with the National Framework, the Care Act of 2014, and the Coughlan case and be able to decide if a person’s care is beyond their legal remit?

7. Local Authorities never get involved in the Continuing Healthcare process if a person has savings

Again, this is nonsense! A person’s money and assets have absolutely nothing to do with the NHS Continuing Healthcare process. It is about healthcare needs ONLY – and the same answer as previously, and Councils have to be involved in the CHC process.

8. NHS Continuing Healthcare Funding only covers 2 hrs care a day

We frequently hear of families being told that NHS Continuing Healthcare is capped. It is not!
There are many instances where people receiving care at home are told they can only have ‘x’ number of visits per day. Again, NHS Continuing Healthcare is not capped, and it must cover ALL assessed healthcare needs, whatever those needs are – including social care needs.

9. You can’t have more than one carer

This is another false statement.
The Continuing Healthcare assessment will determine your relative’s eligibility for CHC Funding and the package of care needed to meet their healthcare requirements. Remember, if an individual is eligible for CHC Funding, the NHS should meet the cost of ALL their assessed care needs, however many carers it takes. Some individuals with complex, intense, and unpredictable care needs may require at least 2 carers (or more) to provide, interpret and manage their day-to-day care needs, including medication and transfers. There is no cap on the number of carers.

10. The Fast Track process only applies if a person has a prognosis of less than three months

Not true. The Fast Track process applies if a person is at end of life OR in a period of rapid decline. The period of rapid decline does not have to be end of life, and there does not have to be an exact prognosis about how many days or weeks a person may or may not have left to live.

If you haven’t read the National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care, it’s a very good idea to familiarise yourself with it, as it will give you extra ammunition for challenging incorrect funding decisions and fighting your relative’s corner during assessment meetings. See our book “How to Get the NHS to Pay for Care” which contains a lot of useful tips and information and is available to buy direct from our website – www.caretobedifferent.co.uk

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