Farley Dwek Blog
Here at Farley Dwek Solicitors, we are passionate about NHS Continuing Healthcare funding (NHS CHC). We believe that everyone should understand what NHS CHC is and why they might be entitled to claim it.
So, what is NHS CHC and how and why should you claim it?
There are two types of NHS CHC claims:
- The first is where a person, who is alive, claims NHS CHC to pay for their care now and for the future.
- The second is where a person has paid for their care in the past, without applying for or being granted NHS CHC, but has now passed away. In this scenario, their next-of-kin may re-claim the previously paid care fees retrospectively.
Either way, in order to obtain NHS CHC, you must be eligible. (Eligibility is a separate topic and one that is covered in detail on our website and in our Free Guide).
Your right to NHS Continuing Healthcare funding
Your legal right to NHS CHC is enshrined in the National Heath Act 1948. The Act sets out the fundamental points to which healthcare is free at the point of delivery.
Everyone has paid for their free care through their taxes and National Insurance contributions. Therefore, claiming for NHS CHC is a legal right. It is the same as if you went to hospital and you had to have an operation. It should be paid for by the NHS.
So, if you are awarded NHS CHC, you are only claiming your entitlement.
It is not the same scenario as if you were claiming against the NHS for negligence. In this scenario, a judgement has to be made and if the NHS are found at fault then they have to pay damages and legal costs. There is the whole dilemma of who is to blame, is it the doctor at fault, why were mistakes made, etc etc.
This is not a case of blaming someone.
When you claim for NHS CHC, you are claiming back your own money that you have paid into the system. This should have been paid for by the NHS originally. You are simply claiming back what you have wrongly paid.
NHS CHC protocols
The protocol for claiming NHS CHC is governed by a National Framework, which has its own rules and claims procedures. However, the NHS is constantly in breach of the rules, in terms of delivering the service, so that claims run on without any real enforcing.
A claim that should last no more than 2 years takes 4 or 5 years. This means that the NHS must pay interest on a longer period than necessary, which is a waste of public money. In the meantime, the person making the claim has to finance their care themselves, often causing much aggravation and stress. People often have to sell their homes to pay for their care funding, or their homes are used as a deferred payment to pay for care until the person dies.
The constant delays by the NHS are a disgrace and Government need to grasp this problem and deal with it. There are currently 160,000 people claiming NHS CHC and many thousands more who have wrongly been denied claims.
The protocols must be adhered to. You can’t go to court to enforce the claim.
The Framework and protocols are just not carried out in a fair impartial way. If you complain about the delay, the NHS will often reply “We don’t have the resources, there is only one nurse dealing with it and they are off for 2 weeks leave, you are number 26 in the queue, you’ll just have to wait”.
So, how do you challenge this?
We have written to MP’s, only to receive wishy washy replies along the lines that the NHS has lack of resources in people and cash to deal with the problem.
We suggest that every person claiming NHS CHC should involve their MP, so that everyone in Government is aware how improperly NHS CHC is being dealt with. After all, the NHS has taken the money wrongly and doesn’t want to pay it back to those who have paid it and doesn’t want to agree the Funding for those who can properly claim it.
The constant deliberate delays caused by the NHS means that many people who are claiming die before the claim is settled and many lose their homes to pay for the care.
In most cases where people wrongly take money from others, there is a remedy in either the criminal courts or by litigation to recover it.
What would happen if MP’s came to claim their expenses and were told that there is only one person who deals with expenses and that they only work 3 half days per week and so the MP’s monthly expenses will be paid in 12 months’ time? What an outcry there would be from the MP’s.
1. ‘I have been told that You have to be at death’s door to receive it’
I wish I had a pound for every time someone has said this to me! It is not true that you have to be but of course if you are then you are likely to qualify for fast track funding if you are not expected to live longer than 12 weeks. However, there are currently 160,000 people wo are in receipt of the funding and many people who qualify for this funding and who go on to receive it for several years.
2. ‘I have been told that there is no point in applying for this funding because the NHS in my area are so short of money that they don’t ever grant the funding to anyone’
This is total nonsense – if you qualify for NHS CHC funding then the NHS is legally obliged to provide it – free at the point of delivery in accordance with the NHS Constitution. Don’t be fobbed off.
3. ‘I have been told that there is no point even being assessed for this funding because my father will never qualify for it’
Nonsense – if you are being discharged from hospital into long term care then you are entitled to be assessed for the funding and at least the first stage of the process which is called a checklist assessment should be carried out before being discharged from hospital. You are of course entitled to request a CHC assessment even if you are transferring into long-term care from your own home.
4. ‘You have to be in a Nursing Home to qualify’
The setting of the care is irrelevant to whether or not you qualify for the funding. It is true that the likelihood of qualifying is higher if you are in a nursing home rather than a residential home or living in your own home by virtue of the fact that people in nursing care are already identified as having a higher level of need which requires the input of a nurse but it is not a bar to qualifying if you are not in a nursing home.
5. Are you still able to apply for NHS CHC Funding if you have savings and own a house?
Yes! This is one of the most commonly held mis-apprehensions about NHS Continuing Healthcare Funding. The assessment of eligibility is based on your health care needs and the care which is required to manage those needs and is nothing to do with your personal wealth or finances. A financial assessment should only be requested by the local authority once the issue of eligibility for Continuing Healthcare funding has been considered.