If your relative has been assessed and is not eligible for NHS Continuing Healthcare, they may be eligible for NHS Nursing Care Contribution.
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If your relative is recommended to enter a care home, then they may be eligible for funding for part or even all of the care fees. Please see our page on NHS Continuing Healthcare to see what the threshold is for eligibility of NHS continuing healthcare (meaning the NHS meets the entire cost of care). However, if your relative is not assessed as eligible for NHS Continuing Healthcare, they may be eligible for NHS nursing care contribution.
If your relative is not eligible for NHS continuing healthcare, but they are in a nursing home (a care home that is registered to provide nursing care) they may be eligible for NHS funded nursing care. This means that the NHS will contribute towards the nursing home fees, known as the Registered Nursing Care Contribution (also referred to as NHS nursing care contribution).
NHS nursing care contribution is only used to pay for the costs of the nursing care element. If your relative is assessed as eligible for NHS nursing care, then they will still be required to pay for their accommodation, board and personal care. However, if your relative’s assets fall below the threshold of £23,250 then the local authority will pay towards care. It should be noted that your relative’s property value can be disregarded in certain circumstances.
The assessment for NHS nursing care contribution should be completed automatically when your relative moves into a nursing home. However, this is sometimes overlooked so you should ensure that the nursing home arranges for this assessment.
NHS nursing care contribution is currently £108.70 per week in England and is usually paid directly to the care home. This contribution should show in reduction of fees but this is often not the case and the decision as to whether it should be will be reflected in the contract between your relative and the care home.
Your relative will have an assessment carried out to see if they are eligible for NHS nursing care contribution. This will be arranged by your local Clinical Commissioning Group. If you contact the nursing home your relative resides in, they will be able to provide you with the relevant details.
Should the assessment show your relative is eligible for NHS nursing care contribution, then the NHS will arrange and fund nursing care provided by registered nurses employed by the nursing home. Services include things such as planning, supervising and monitoring nursing and healthcare tasks, as well as direct nursing care.
Prior to September 2007, there was a three-tiered system for nursing care. Anyone who was assessed as the highest band of NHS funded nursing care can continue to receive this until their care needs change. Currently the high band of NHS nursing care is £149.60 per week.
Before any assessment for NHS nursing care contribution is carried out, the NHS is under a duty to complete a NHS continuing healthcare checklist which assesses whether your relative has a health need therefore the NHS meet the entire cost of care. This assessment alone may indicate that your relative is not eligible for NHS continuing healthcare but does have care needs that meets the threshold to be eligible for NHS funded nursing care.
Should your relative have an assessment for either NHS continuing healthcare or NHS nursing care contribution and the outcome is that they are not eligible; the NHS is under a duty to explain this clearly to both the patient and their representative. In the letter detailing the outcome, the NHS should provide details on how you can appeal a decision.
If you would like to know more about the appeal procedure, please have a look at our Appealing A Decision page. We can assist at any point during the process.