What is NHS-Funded Nursing Care (FNC) and What Does It Pay For?

What is NHS-Funded Nursing Care?

NHS-Funded Nursing Care is funding provided by the NHS to care homes with nursing to support the provision of nursing care by a registered nurse. It is commonly referred to as FNC.

Unlike NHS Continuing Healthcare (CHC), FNC does not fund the whole of a person’s care package. It is a contribution towards registered nursing care and is paid by the NHS directly to the nursing home, rather than to the resident or their family.

Who is eligible for Funded Nursing Care?

A person may be eligible for FNC where:

• They live in a care home that provides registered nursing care
• They require care from a registered nurse, and
• They do not qualify for NHS Continuing Healthcare

That final point is important. NHS guidance states that a person must be considered for NHS Continuing Healthcare before a decision is reached about their eligibility for FNC.

The two forms of NHS funding are very different. If your relative qualifies for CHC, the NHS is responsible for arranging and funding a package to meet their assessed health and associated social care needs. FNC, by contrast, is a contribution towards registered nursing care.

An FNC award should therefore not be treated as a substitute for properly considering whether your relative has a primary health need and qualifies for CHC.

What does Funded Nursing Care pay for?

FNC contributes towards nursing care by a registered nurse.

This covers more than the occasions when a nurse personally carries out a nursing intervention. Relevant nursing input can include:

• Providing direct nursing care;
• Care planning;
• Monitoring a resident’s condition;
• Supervising nursing care; and
• Time spent by a registered nurse monitoring or supervising care delegated to other staff.

FNC does not fund the wider non-nursing care or accommodation provided by the nursing home. This distinction matters. A person can have substantial care needs but receive only FNC if they have been assessed as not eligible for NHS Continuing Healthcare.

What is the current NHS-Funded Nursing Care rate?

From 1 April 2026, the standard NHS-Funded Nursing Care rate in England is £267.68 per week.

This increased from £254.06 per week in 2025/26.

There is also a higher rate of £368.24 per week for people who remain entitled to the former high-band rate under arrangements that pre-date the current single-band system.

The rate is set nationally, and the NHS pays it directly to the nursing home.

Will FNC be deducted from my relative’s nursing home bill?

Not necessarily in the way families sometimes expect.

The care home should set an overall fee for the care and accommodation it provides, including registered nursing care. Where your relative is eligible for FNC, the NHS pays the nationally agreed contribution directly to the nursing home. The balance is then paid by the resident, their representative or the local authority, unless different contracting arrangements have been agreed.

The practical effect on the amount your relative pays can therefore depend on the contractual arrangements with the care home.

If your relative has been awarded FNC, check:

• The care home’s contract and fee terms
• Invoices issued before and after the FNC award
• Whether the quoted fee is inclusive or exclusive of FNC
• The date from which the FNC award applies; and
• How the nursing home has accounted for the NHS contribution.

If the invoices do not make this clear, ask the care home for a written breakdown showing how the FNC payment has been treated.

What happens after an award of FNC?

An FNC award is not necessarily permanent.

A review should normally take place within three months of the eligibility decision and at least annually thereafter.

The review should consider whether your relative’s nursing needs are being appropriately met. It should also consider whether their needs have changed so that they may now require NHS Continuing Healthcare.

FNC can cease if, for example:

• Your relative no longer requires registered nursing care;
• They are no longer living in a care home that provides registered nursing care;
• They become eligible for NHS Continuing Healthcare; or
• They die.

Keep copies of FNC decisions and subsequent reviews, particularly if your relative’s health or care needs are changing.

Can someone receiving FNC later qualify for NHS Continuing Healthcare?

Yes. Receiving FNC does not prevent your relative from qualifying for CHC later.

If their needs materially change, their potential eligibility for NHS Continuing Healthcare may need to be considered again. During an FNC review, consideration should be given to whether the person now needs CHC.

When assessing whether needs have changed, consider the reality of your relative’s care throughout the day and night, rather than focusing only on their diagnoses.

Relevant evidence can include:

• Care plans and daily care records
• Nursing notes
• Medication records
• Incident and accident records
• Behaviour or monitoring charts
• Hospital and GP records
• Specialist reports; and
• Records showing deterioration, increased interventions or greater supervision.

Where CHC eligibility is being considered, the nature, intensity, complexity and unpredictability of the person’s needs are relevant to deciding whether they have a primary health need.

A need should not be discounted simply because it is being successfully managed. The care and intervention required to manage that need remain relevant.

What if FNC was awarded after CHC was refused?

An FNC award does not, by itself, establish that a CHC refusal was correct.

If your relative underwent a full CHC assessment before FNC was awarded, consider whether the assessment accurately reflected their needs and whether the available evidence was properly taken into account.

In particular, compare the Decision Support Tool (DST), if one was completed, with the underlying care and clinical records. Look for:

• Needs that have been understated or omitted
• Significant incidents missing from the assessment
• Descriptions that do not reflect the frequency of interventions recorded in the evidence
• Reliance on a brief assessment-day snapshot rather than longer-term records
• Well-managed needs being treated as though they no longer exist
• Inconsistencies between the DST and nursing, medical or care records
• Conclusions about the primary health need that do not appear to follow from the evidence recorded.

Not every FNC award following a CHC refusal means that the CHC decision was wrong. The issue is whether the decision accurately reflects your relative’s assessed needs and whether the National Framework was properly applied.

If the assessment does not appear to reflect the evidence, you may have grounds to challenge the CHC decision. The appropriate next step will depend on the stage of the process, the reasons given for the refusal, and the supporting care and clinical evidence.

What should you do if you are unsure about an FNC award?

Start by establishing exactly what has been decided and why.

Depending on the assessment your relative has undergone, ask for copies of:

• The written FNC eligibility decision
• The CHC Checklist, if one was completed
• The Decision Support Tool, where there has been a full CHC assessment
• The written CHC eligibility decision and rationale
• The nursing needs assessment
• Relevant care, nursing and medical records
• The nursing home’s contract and recent invoices if you are questioning how FNC has affected the fees

These documents can help answer two separate questions:

1) Has the NHS made the correct funding decision, and
2) Has the resulting FNC payment been correctly accounted for in the nursing home’s fees?

Keeping those issues separate can make it easier to identify what needs further investigation or challenge.

How Farley Dwek can help if FNC follows a CHC refusal

If your relative has been awarded FNC after being refused NHS Continuing Healthcare and you are concerned that the CHC decision does not reflect their actual needs, Farley Dwek can review the funding decision and the evidence behind it.

Our specialist solicitors and experienced nurses can examine the Decision Support Tool alongside care, nursing, and medical records, identify factual or procedural concerns, and advise on whether there are reasonable grounds to challenge the CHC decision.

Where an appeal is appropriate, we can also assist with reviewing and presenting the evidence and preparing written submissions to challenge the refusal.

An FNC award may be entirely appropriate. However, where your relative has substantial health needs, and the CHC assessment appears inconsistent with the evidence, the decision should be examined rather than assuming FNC is necessarily the correct level of NHS funding.

If you are concerned that FNC has been awarded instead of CHC, speak to our NHS Continuing Healthcare appeals team about reviewing the decision and supporting evidence.