In a recent article for the Sunday Times, Ali Hussain collated stories of individuals who were involved in trying to secure NHS Continuing Healthcare Funding (NHS CHC) for elderly family members. NHS Continuing Healthcare Funding is available where someone has been assessed as having a primary health need and there is no other payment being made for their care; e.g. through a settlement of a personal injury or medical accident claim where an award has been made to include future care.
In order to qualify for NHS CHC, 12 domains need to be addressed including behaviour, cognition, communication, psychological or emotional needs, mobility, nutrition, continence, skin (including wounds and ulcers), breathing, symptom control through drug therapies and medication, altered states of consciousness and other significant needs.
An assessment will look at the unpredictability, intensity, complexity and severity of the needs in each domain and how they interact.
NHS CHC will only be recommended if somebody has a number of domains which score highly. The benefit of NHS CHC is that it is non means tested, compared with care needs provided under the social care budget, which are means tested. It can seem extremely unfair for those who require care that their care needs are not catered for by the NHS. Nonetheless the NHS is a health service and if someone’s care needs are not health related it is appropriate that responsibility for their care lies with the social care system. This means the individual will be self funding unless their assets fall below £23,250 when a contribution will be made by the state. It is only when individual assets fall to £14,250 that the state will pay for care in its entirety. There are however other areas which may be worth considering such as personal health budgets, funded nursing care, direct payments and attendance allowance.
If you are worried about going into care we can assist with making an application to the NHS Continuing Healthcare Funding. We can also assist with claims There are some circumstances where we will want to consider whether care should be provided by a third party eg if accidental injury or a deteriorating medical condition has been caused by a negligent act. This could be an injury such as a broken hip leading to physical incapacity, or brain injury that has been caused by someone else. If care in hospital has been inadequate and caused an overall worsening of health then this might give rise to a claim. We would assess whether there might be a claim for negligent medical treatment if this arose within the last three years.
If you or an elderly relative need advice regarding access to health or social care provision then contact a member of our Elderly Care Team on 0345 209 1495.
If you are concerned about the quality of medical treatment given to yourself or a relative, contact a member of our Medical Negligence Team on 0345 209 1055.