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9 March 2016 | Comment | Article by Lisa Morgan

New figures released show postcode lottery for help with healthcare funding remains


We have previously written about the postcode lottery that exists in NHS Continuing Healthcare funding in England. Recent Health and Social Care Information Centre figures show that unfortunately this postcode lottery still exists.

NHS Continuing healthcare is a package of care arranged and funded solely by the NHS, which can be received in hospital, a nursing home or at the individual’s own home. It is often described as ‘fully funded care’. If you demonstrate a primary health need then the NHS must pay for your care in full, regardless of your personal wealth. Such care is provided to individuals who are over 18,andto meet needs that have arisen as a result of injury, illness or disability.

The cost of care in England can be in excess of£1,000 a week so the cost of footing the bill for care can quickly increase. If an individual is not funded by the NHS they will be means tested by the local authority. This can result in the sale of an individual’s home to pay for care.

The guidance on who is eligible for this funding is the same throughout England and is set out in the National Framework for NHS Continuing Healthcare Funding and NHS funded Nursing Care(November 2012). Despite the guidance and criteria being the same, who gets this funding varies dramatically in different parts of England.

In the most recent figures released by the Health and Social Care Information Centre(15 December 2015),it identifies that 62,854people are eligible for NHS Continuing Healthcare Funding in England. This averages to 69 people out of every 50,000.This demonstrates a 1.5 percent increase in the number of people eligible since the last figures released in June 2015.

Examples of this variance include; NHS South Reading fund an average of 12 people out of every 50,000,which could mean than 83percent of those who may be eligible for NHS Continuing Healthcare in South Reading are not receiving it, while NHS Salford funds an average of 214 in every 50,000. Further examples are NHS Hull which fund an average of 115 in every 50,000and NHS Oxfordshire which fund an average of 21 in every 50,000.

These figures demonstrate that there is a huge variation throughout the country, which is resulting in a great unfairness for people who are paying for care when they should not be. Whilst it is to be expected for there to be a variation between different areas due to differences in the population, some of the variations are simply too great to be put down to differences in the population.

So what should you do if you feel your relative has been unfairly denied funding?

As experts in challenging NHS Continuing Healthcare decisions Hugh James Nursing Care offer a free no obligation assessment. By completing a simple questionnaire providing details about your relative’s health and care needs we will be able to advise you if there are prospects of successfully obtaining NHS Continuing Healthcare funding for your relative.

For further information, visit our nursing care fees recovery pages to find out if you or a family member are eligible to reclaim care home fees.

Author bio

Lisa Morgan is a Partner and Head of the Nursing Care department. She is regarded as an experienced and specialist solicitor leading in the niche area of continuing healthcare.

She has been instrumental in developing a niche legal department in Hugh James, which comprises of 40 fee earners who solely act for the elderly and families in recovering wrongly paid nursing fees.

Disclaimer: The information on the Hugh James website is for general information only and reflects the position at the date of publication. It does not constitute legal advice and should not be treated as such. If you would like to ensure the commentary reflects current legislation, case law or best practice, please contact the blog author.

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