Nursing care in Wales: when does the NHS pay?
Some people affected by dementia may be eligible for NHS-funded nursing care contribution.
- Paying for care and support in Wales
- What is the care assessment process in Wales?
- Paying for care in Wales: Support at home
- Who pays for care home fees in Wales?
- You are here: Nursing care in Wales: when does the NHS pay?
- Paying for care in Wales: complaints and FAQs
- Paying for care in Wales: useful resources
Can the NHS cover the full cost of my care?
Some people may be entitled to receive NHS continuing healthcare (CHC) funding. This is funding from the NHS that will cover the full cost of your care – if you are deemed to have a healthcare need – whether in your own home, or in a care home.
It is difficult for people with dementia to meet the eligibility criteria because they are often assessed as having social care needs rather than healthcare needs. This is a complex area, particularly for people with dementia, because telling the difference between these two types of care can be very difficult.
When does the NHS pay for care?
Find our what NHS continuing healthcare is, how to get an assessment and how to appeal if you think you have been wrongly charged for care.
Can I still get NHS funding if I don't qualify for NHS continuing healthcare?
If you need nursing care but you don’t qualify for NHS continuing healthcare, you might still be able to receive the NHS-funded nursing care (FNC) contribution. This is only paid if you are assessed as needing nursing care in a care home that is registered to provide nursing care.
The nursing care contribution is a flat weekly amount paid directly to the care home to cover the additional cost of having a nurse at the home. It will not cover the majority of your fees. In Wales, the standard rate is £179.97 weekly.
It is also possible to have a higher level of nursing care paid for by the NHS, if you have a joint package of care (meaning it is paid for jointly by the local authority and the NHS).
In this case, some care is assessed as healthcare and is funded by the NHS, and some is social care and therefore means-tested. This may happen if your nursing care need is more than the basic nursing care contribution can provide but you are not eligible for NHS continuing healthcare funding.
In both of these cases, any social care element will be funded either by you or the local authority, depending on your financial assessment.
If you are paying for your own care in a nursing home, you can still be eligible for the NHS-funded nursing care contribution. This does not affect your benefits, and should reduce the cost of your care home fees.
The care home should give you a written statement with a clear breakdown of how much of the costs are covered by the NHS, the local authority and yourself. You can ask them for a statement if you haven’t been given one.