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NHS Continuing Healthcare

In order that we are able to provide a full range of services to our clients we work closely with Underwoods Solicitors in the area of NHS Continuing Healthcare.

Underwoods Solicitors is one of the few firms assisting people to make applications for NHS continuing healthcare on behalf of nursing home patients.

Continuing healthcare involves the NHS funding the care of patients who need continuing medical treatment that is provided outside a hospital environment, primarily in nursing homes, but this can also apply to people receiving care in other settings, including their own homes.

A person is eligible for continuing healthcare if they have a high level of medical need. This is assessed by looking at the different aspects of the care needed focusing on issues such as;

  • their cognition
  • their ability to communicate
  • their mobility, and
  • the medication they require.

The NHS also looks at the complexity, intensity and unpredictability of the patient’s needs; in plain English that means

  • how much care they need,
  • how complicated their treatment is, and
  • if their needs or behaviour are unpredictable.

A patient’s next of kin can make an application after the patient has passed away if this is applicable.

Key issues when making the application

  • When were care costs incurred?
    If this was before 31 March 2012 then it is too late to claim for those fees but later fees can still be claimed for. It is still be possible to apply in respect of fees incurred from 1 April 2012 but the government are looking at changing the way care is funded so we do not know how long this option will be available.
  • Who to apply to?
    The NHS Clinical Commissioning Group for the area where the patient lived when they were found to need care. Information about the patient’s GP is essential to making this decision.

Things that an application WILL do:

  • Give you the opportunity to have the needs of you, your relative or friend assessed to see if they are eligible for help funding the potentially enormous cost of nursing care which can ensure they receive a high standard of care when they need it most.
  • Take a long time. The precise duration varies depending on where you live but you must be prepared to be patient.
  • Require you to consider and discuss in detail the problems and illnesses the patient has or had. This can be particularly difficult where a person’s behaviour changed as a result of an illness such as dementia and it is important not to feel that you are criticising them or insulting their memory and to try to avoid sanitising the information you provide.
  • Require you to know about the patient’s needs. If you have little or no knowledge of their problems and the care they required then it may not be possible to complete the long and detailed forms. This can be overcome by obtaining medical records.
  • Require proof of your legal authority. If the patient has problems with capacity or has passed away and you do not have power of attorney or deputyship or are not an executor or administrator, then this can cause you problems and we need to know this from the start to be able to help you.

Things that an application WILL NOT do:

  • Make the patient exempt from paying for their care while the application is being processed.
  • Allow you to complain about standards of NHS care or standards of care in a nursing home. If you have complaints about these then they need to be dealt with separately.