NHS continuing care

What is NHS continuing healthcare?

NHS continuing healthcare (also known as NHS continuing care and fully funded NHS care) is a package of care arranged and funded solely by the NHS. It is awarded depending on whether a person's primary need is a health need. It can be provided in a range of settings, including an NHS hospital, a care home or someone's own home.

What is the National Framework for NHS continuing healthcare?

In October 2007 the Department of Health produced new guidance that sets out a system for deciding eligibility for NHS continuing healthcare. This is called the National Framework for NHS Continuing Healthcare and NHS funded Nursing care. The Framework sets out the factors that are considered to decide whether someone meets the criteria for NHS Continuing Healthcare.

Alzheimer's Society campaigned for many years for national eligibility criteria for NHS continuing healthcare and therefore welcomed the introduction of the National Framework for NHS continuing healthcare. Since its introduction, the number of people receiving NHS continuing healthcare has increased from 27,822 at the end of September 2007 to 46,599 at the end of March 2009. It is encouraging that more people are receiving NHS continuing healthcare but it is important to note that this figure includes people with all types of illness and not just dementia.

When does the NHS pay for care?

Alzheimer's Society booklet When does the NHS pay for care? explains what NHS continuing healthcare is, how to get an assessment and how to complain if you think you have been wrongly charged for care. 

Applying for NHS continuing healthcare is not an easy process to go through or to understand. We cannot tell you whether a person with dementia is eligible for NHS continuing healthcare. The guidance applies to people in England, but much will also be applicable to people in other parts of the UK.

Changes to appeal timescales

If someone is turned down for NHS contiuing healthcare, an appeal can be made against the decision.  In March 2012 the Department of Health announced some changes to timescales for appealing NHS Continuing Care decisions.

From 1 April 2012 people will have 6 months from the date of a decision to begin an appeal with the PCT concerned.

The PCT will then have 3 months to conduct the review.
The person will then have 6 months to begin an appeal with the SHA.
The SHA will then have 3 months to conduct the review.

These rules will not apply retrospectively.  However, they are also introducing a deadline for historic appeals to be brought to PCTs. 

If you would like to appeal a decision from before 31 March 2011 you need to do so before 30 September 2012.

If you would like to appeal a decision from between 1 April 2011 and 31 March 2012 you need to do so before 31 March 2013.

 

NHS continuing care volunteer support group

People who believe they have wrongly been denied access to NHS continuing care funding can contact the Alzheimer's Society NHS continuing care volunteer support group to help them challenge decisions.