The True Cost of Care

If you are assessed as having significant ongoing healthcare needs you may be able to benefit from a free package of care known as NHS Continuing Healthcare. If eligible, the NHS will fully fund not only the cost of your healthcare but any associated social needs too. If you become resident in a care home this would cover the cost of your board and accommodation as well as care – in full. So you can be safe in the knowledge that (as long as you continue to meet the criteria) the cost of your care is covered.

Sadly not everyone with health needs will meet the criteria for NHS Continuing Healthcare. The good news is that if you are resident in a care home and require the services of a registered nurse you should be eligible for NHS funded nursing care. This is an arrangement whereby the NHS will pay a set weekly amount directly to the care home which goes towards the cost of the registered nursing care – which has recently been increased to £156.25 per week. The bad news is that this may not necessarily reduce the amount you physically have to pay yourself.

So why the uncertainty? It all boils down to the wording of the guidance issued by the Department of Health which says that the payment “should” be reflected in the fee actually charged by the care home, not that it must be – and it would appear that some homes are taking advantage of this ambiguity when drafting their contracts, allowing them to ‘pocket’ this payment whilst collecting full fees from residents. This guidance could be interpreted in a way that requires care homes to either reduce their fees proportionately or account to the patient for the amount paid by the NHS. But what does “accounting to the patient” mean?

It could be argued that the failure of care homes to reduce their fees in these circumstances is inequitable, particularly when you consider that the contribution is only made by the NHS because the person meets the criteria – why should they not get the benefit of it? In contrast, where full continuing healthcare is funded by the NHS the care home cannot demand any further payments from the resident. This begs the question - why are the NHS contributions towards funded nursing treated differently to full continuing healthcare?

                                               

If you would like any more information on care home funding and costs please contact Mike Talbot on 0161 785 3500.

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Please note that the information and opinions contained in this article are not intended to be comprehensive, nor to provide legal advice. No responsibility for its accuracy or correctness is assumed by Pearson Solicitors and Financial Advisers Ltd or any of its members or employees. Professional legal advice should be obtained before taking, or refraining from taking, any action as a result of this article.

This blog was posted some time ago and its contents may now be out of date. For the latest legal position relating to these issues, get in touch with the author - or make an enquiry now.