Not all care benefits are means-tested. In fact, the UK government provide a large variety of NHS benefits based solely on an individual’s health and care needs. These are provided through the NHS in England. It is extremely important that, with the support of your later life financial planning specialist, you explore the possibility of these benefits. For individuals assessed as ‘self-funders’, it could mean the difference between paying for your entire care journey yourself and having everything paid for by the NHS.
Following are the different care benefits based on solely on health and care needs that are available to all individuals, regardless of assets and income.
NHS Continuing Healthcare (CHC)
What is NHS Continuing Healthcare (CHC)?
Continuing Healthcare (CHC) is free care that is arranged and funded by the NHS in England, for adults with long-term complex health needs.
NHS Continuing Healthcare can be provided in your own home, where the NHS will pay for nursing and personal care, or in a care home, whereby the NHS will pay the care home fees.
Older patients discharging from hospital should be assessed for NHS Continuing Healthcare before being discharged from hospital.
Who qualifies for NHS Continuing Healthcare?
To be eligible for NHS Continuing Healthcare, you must be an adult and be assessed by a team of healthcare professionals as having long-term complex health needs. These needs must be assessed as being complex, intense and/or unpredictable in their nature.
How much will CHC contribute to my care costs?
Continuing Healthcare (CHC) can cover up to 100% of care costs, including healthcare (for example services from a nurse or therapist) and personal care (for example help with washing, dressing and laundry).
How to request an assessment
If you or a loved one you care for is in hospital, it is a good idea to discuss NHS Continuing Healthcare when you approach discharge. You can speak to your doctor or social worker if you think you might be eligible for NHS Continuing Healthcare. Alternatively, speak to us and we can help to identify if you may be eligible for CHC and sign-post you to the relevant organisation depending upon your circumstances.
How to prepare for your NHS Continuing Healthcare Assessment
- Gather the most up-to-date evidence You may want to discuss the assessment in advance with your care home or care agency. This will enable them to ensure that all relevant records such as care plans, risk assessments and daily records are up to date.
- Ask for a care plan review You may want to consider asking your care home manager or care agency to review your care plan. You can then use this to check the details of each element of your care that will be considered in the assessment paperwork, i.e The Decision Support Tool.
- Detail any complex issues If there is an area of care that is particularly complex, for example, challenging behaviour or falls, it may be useful to ask the care home manager or care agency to ensure that recent records pertaining to this are available. It may even be appropriate to ask them to keep a detailed one-week log of all events related to that particular care need in the lead up to the assessment.
- Make a diary If you are a representative of the person who is to be assessed, it can help during the assessment if you are able to present a written record of your visits to the person in a diary format. Therefore, each time you visit the person, make a record of your visit. Consider how the person appeared to be, for example, did they greet you? Were they asleep? Did you assist them to eat and drink? Did they show any signs of challenging behaviour?
- Keep the relevant paperwork for your CHC assessment Do store in a safe place all the documentation sent to you relating to both your Continuing Healthcare screening Checklist and your Full Assessment.
- Jot down questions Make a list of any questions you want to ask your coordinating assessor about the Continuing Healthcare assessment process. Potential questions could be around timescales for completion, completion of the decision support tool, care planning or how to appeal if you are not awarded Continuing healthcare.
What to expect
An initial assessment will be completed by a nurse, doctor, other healthcare professional or social worker. This involves a checklist that looks at 11 out of 12 areas related to an individual's care needs. For each area, the person's needs are categorised as either:
- A (High need)
- B (Moderate need)
- C (Low/No need)
Depending on the outcome of the assessment, you’ll either be told that you don’t meet the criteria for a full assessment of NHS continuing healthcare and are therefore not eligible, or you’ll be referred for a full assessment of eligibility.
To see whether you qualify for NHS Continuing Healthcare, a healthcare team will use paperwork known as the Decision Support Tool (DST) to assess the:
- Complexity of your needs
- Intensity or severity of your needs
- Extent to which your needs may be unpredictable, and any potential effects on your health
The team’s assessment will consider your needs under the following headings:
- Breathing
- Nutrition (food and drink)
- Continence
- Skin (including wounds and ulcers)
- Mobility
- Communication
- Psychological and emotional needs
- Cognition (understanding)
- Behaviour
- Drug therapies and medication
- Altered states of consciousness
- Other significant care needs
How often will it be reviewed?
If you are eligible for and begin an NHS Healthcare package, this should be reviewed within the first three months and at least every year after this.
This is to check whether the package of care agreed still meets your needs, or if changes are needed.
Can I pay top-up fees for NHS Continuing Healthcare?
No, unlike with Local Authority funding, you can’t pay top-up fees for NHS Continuing Healthcare packages.
Can I fast-track my application?
Yes, if someone's health is deteriorating rapidly and may be entering a terminal phase, there's a fast-track option available to ensure they receive timely care. . The fast-track pathway replaces the need for the checklist and the more comprehensive assessment to be completed. However, a fast-track pathway can also be adopted after the checklist if it becomes apparent at that point that the fast-track criteria are met.
What can I do if I’m not eligible for NHS Continuing Healthcare?
If your assessment doesn’t qualify you for NHS Continuing Healthcare but does assess you as needing a registered nurse, you may be eligible for NHS-funded Nursing Care. This is when the NHS pays for the nursing care component of nursing home fees.
NHS Funded Nursing Care (FNC)
NHS-Funded Nursing Care (FNC) is a financial contribution provided by the NHS to cover expenses associated with nursing or medical care for individuals residing in care homes or nursing homes. This care is administered by registered nurses and is also known as Registered Nursing Care Contribution. The NHS provides funding for FNC in England.
Who qualifies for NHS Funded Nursing Care (FNC)?
FNC is available to individuals who meet the following criteria:
- They do not qualify for NHS Continuing Healthcare (CHC) but have been assessed as requiring the services of a registered nurse in a care home with nursing.
- They reside in a care home that is registered to provide nursing care.
- They have been assessed and deemed to require the care of a registered nurse.
FNC is not subject to means testing through financial assessments, meaning that income and savings do not factor into the decision. Eligibility can be established regardless of whether the individual is personally covering their care costs or if the local authority is responsible for payment.
How much will FNC contribute to my care costs?
FNC has been based on a single-band rate since 2007. If an individual is eligible the care home will be paid the nationally agreed rate directly. The remainder of the care home fees will be the responsibility of the individual, their representative, or the local authority (or a combination of these), unless alternative payment arrangements have been made.
The standard nursing care rate is £267.68 per week in England for 2026.
Some individuals in England may receive weekly payments of £324.50 if they qualified for the highest rate of FNC before October 1, 2007, and continue to do so.
How to request an assessment
In most cases, there is no need for a separate assessment for FNC if a comprehensive multidisciplinary assessment for NHS Continuing Healthcare has already been conducted. However, if necessary, health authorities can arrange a separate nursing needs assessment to determine eligibility for FNC. For example, if the individual was not found to be eligible for NHS Continuing Healthcare but has now gone into or thinking about going into a nursing home.
How often will it be reviewed?
FNC reviews are typically conducted after the initial three months and then at least annually to reassess eligibility and ensure the level of care is appropriate. Eligibility for FNC may change under the following circumstances, resulting in payments ceasing:
- Hospitalization: Individuals receive free nursing care during hospitalization, and NHS contributions toward nursing care fees cease
- No longer requiring nursing care
- Becoming eligible for NHS Continuing Healthcare
What can I do if I’m not eligible for NHS-Funded Nursing Care?
If there are concerns or disagreements regarding the FNC decision, individuals or their representatives can request a review through their Integrated Care Board (ICB) or use the ICB complaints process to seek resolution.
Renablement Care
The local council may be able to provide free care and support at home for up to 6 weeks after a stay in hospital or to prevent you going into hospital. This will cover personal care, such as help with daily living activities and other practical tasks. It is also known as intermediate care or aftercare.
These services can assist to maximise your independence and prevent prolonged stays in hospital that may be detrimental to your health.
It tends to be provided to people who have just been discharged from hospital or are entering the care system following a crisis. It can also help people leave hospital as soon as they’re able to, as they’ll have support when they return home.
You usually do not have to apply for reablement care. Hospital staff, including the discharge co-ordinator, will assess you on discharge to determine whether you need further help to recover. If they think you do, they will arrange care before you leave the hospital.
If you feel you or a loved one has not been assessed properly following discharge contact social services (not the hospital):
Next Steps
If you are looking for care fee planning advice as a self-funder, we have SOLLA (Society of Later Life Advisers) Accredited Advisers happy to talk through your individual circumstances. Give us a call on 0117 3636 212 or email office@haroldstephens.co.uk.
