The hidden cost of care
Families across England and Wales face the rising financial burden of paying for long-term care. With average care home fees exceeding £67,500 per year, many people assume they must pay simply because they have savings or own a home. It is a common misconception that entering a care home automatically makes you liable for your own expenses.
In fact, if a person requires care as a result of their health – not just their social needs – the NHS is responsible for meeting all of their care costs. Yet thousands of people are wrongly denied this support every year, and the consequences can be financially devastating.
At Hugh James, we regularly hear from families who feel overwhelmed, frustrated and unsure where to turn after being told their loved one is ineligible. Our experience shows that many of these decisions are incorrect – and families often end up wrongly paying for years.
What is NHS Continuing Healthcare (CHC)?
NHS Continuing Healthcare (CHC) is a package of care arranged and funded entirely by the NHS for individuals whose primary need is health-related. Unlike means-tested social care, CHC is not dependent on personal savings, property ownership or income.
To qualify, a person must be assessed against strict criteria. The test is whether someone has a ‘primary health need’, which means their needs are:
- intense – requiring frequent or sustained care
- complex – involving multiple interrelated conditions
- unpredictable – with fluctuating or difficult-to-manage symptoms
- severe in nature – impacting multiple aspects of daily living
- When determining eligibility, assessors consider areas such as:
- long- and short-term memory
- mobility and risk of falls
- need for medication management
- nutrition and hydration
- continence care
These examples make clear that CHC is not limited to acute hospital needs. Many residents with dementia, Parkinson’s or advanced frailty meet the criteria but are still wrongly told to self-fund.
Unfortunately, the system is inconsistently applied. Families are often told their loved one’s needs are “social” rather than “health” related assessments are rushed or carried out without proper evidence funding is withdrawn after reviews despite no real improvement. These errors mean that many who should qualify for CHC are left to pay for care themselves.
The cost of getting it wrong
The scale of the problem is significant. Out of 440,000 care home residents in the UK, around 40% are self-funding their care. With average annual fees exceeding £67,500, families can spend hundreds of thousands of pounds over several years.
The impact is not just financial. Paying wrongly can drain savings built up over a lifetime, force the sale of family homes and create huge emotional stress during already difficult times.
Successes and expertise
At Hugh James, our Nursing Care team has specialised in challenging incorrect CHC decisions for nearly two decades. Since 2006, we have recovered more than £250 million in wrongly paid care fees for over 6,000 families.
As our Head of Nursing Care, Lisa Morgan, explains:
“Over £250 million of redress has now been won for our clients. Each case is different, but the common theme is that families should not have had to pay for care that was rightly the responsibility of the NHS.”
This proven track record makes us the leading UK law firm in this highly specialist area.
Real stories from our clients
Despite repeated refusals, Mrs Homewood’s family persevered with our support. We proved her needs were health-related and secured over £100,000 in reimbursements.
- Barbara Stretch – £43,000 plus £12,000 interest
After years of delays by the NHS, Mrs Stretch’s family recovered £55,000 in total, including interest, for wrongly paid fees.
- Eric Halloway – £170,000 recovered after eight-year fight
Mr Halloway’s case shows just how complex the system can be. His family endured years of frustration, but we ultimately secured £170,000 in wrongly paid fees.
- Hilda Underwood – £35,000 for final year of care
Even in her final year, Mrs Underwood’s care should have been fully funded. We recovered £35,000, bringing closure and recognition for her family.
These stories illustrate the real difference CHC funding makes. For more examples, visit our case studies page to see how we have helped families like yours.
